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Guo X, Qin L, Tian J, Li P, Dou Z, Gong Y, Wang H. Development and validation of a prognostic nomogram for esophageal cancer patients based on SEER Asian population. Sci Rep 2024; 14:21475. [PMID: 39277664 PMCID: PMC11401934 DOI: 10.1038/s41598-024-72730-3] [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: 06/14/2024] [Accepted: 09/10/2024] [Indexed: 09/17/2024] Open
Abstract
This study aims to develop and validate a nomogram for predicting overall survival (OS) in Asian patients with Esophageal Cancer (EC). Data from Asian EC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for initial variable selection, followed by multivariate Cox regression analysis to identify independent prognostic factors. A nomogram was subsequently constructed based on these factors. The predictive performance of the nomogram was evaluated using receiver operating characteristic (ROC) curves and calibration curves, while the clinical utility of the nomogram was assessed through decision curve analysis (DCA). The LASSO regression and multivariate Cox regression analysis identified age, sex, marital status, tumor size, M stage, surgery, and chemotherapy as independent prognostic factors. The ROC curve results demonstrated that the area under the curve (AUC) values for predicting 1-year, 3-year, and 5-year OS in the training cohort were 0.770, 0.756, and 0.783, respectively. In the validation cohort, the AUC values were 0.814, 0.763, and 0.771, respectively. Calibration curves indicated a high concordance between predicted and actual OS. The DCA demonstrated that the nomogram has significant clinical applicability. This nomogram provides reliable predictions and valuable guidance for personalized survival estimates and high-risk patient identification.
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Affiliation(s)
- Xinwei Guo
- Department of Radiotherapy, Taixing People's Hospital Affiliated to Yangzhou University, No. 1, Changzheng Road, Taixing City, 225400, Jiangsu Province, China.
| | - Lang Qin
- Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China
| | - Jie Tian
- Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China
| | - Pengcheng Li
- Department of Oncology, Anhui University of Science and Technology First Affiliated Hospital, Huainan, China
| | - Zhenling Dou
- Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China
| | - Yu Gong
- Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China
| | - Haobiao Wang
- Department of Oncology, Anhui University of Science and Technology First Affiliated Hospital, Huainan, China
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Fan Z, Zhou J, Tian Y, Qin Y, Liu Z, Gu L, Dawsey SM, Wei W, Deng D. Somatic CDKN2A copy number variations are associated with the prognosis of esophageal squamous cell dysplasia. Chin Med J (Engl) 2024; 137:980-989. [PMID: 38445358 PMCID: PMC11046026 DOI: 10.1097/cm9.0000000000002982] [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: 09/07/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Somatic copy number variations (SCNVs) in the CDKN2A gene are among the most frequent events in the dysplasia-carcinoma sequence of esophageal squamous cell carcinoma. However, whether CDKN2A SCNVs are useful biomarkers for the risk stratification and management of patients with esophageal squamous cell dysplasia (ESCdys) is unknown. This study aimed to investigate the characteristics and prognostic value of CDKN2A SCNVs in patients with mild or moderate (m/M) ESCdys. METHODS This study conducted a prospective multicenter study of 205 patients with a baseline diagnosis of m/M ESCdys in five high-risk regions of China (Ci County, Hebei Province; Yanting, Sichuan Province; Linzhou, Henan Province; Yangzhong, Jiangsu Province; and Feicheng, Shandong Province) from 2005 to 2019. Genomic DNA was extracted from paraffin biopsy samples and paired peripheral white blood cells from patients, and a quantitative polymerase chain reaction assay, P16-Light, was used to detect CDKN2A copy number. The cumulative regression and progression rates of ESCdys were evaluated using competing risk models. RESULTS A total of 205 patients with baseline m/M ESCdys were enrolled. The proportion of ESCdys regression was significantly lower in the CDKN2A deletion cohort than in the diploid and amplification cohorts (18.8% [13/69] vs. 35.0% [28/80] vs. 51.8% [29/56], P <0.001). In the univariable competing risk analysis, the cumulative regression rate was statistically significantly lower ( P = 0.008), while the cumulative progression rate was higher ( P = 0.017) in ESCdys patients with CDKN2A deletion than in those without CDKN2A deletion. CDKN2A deletion was also an independent predictor of prognosis in ESCdys ( P = 0.004) in the multivariable analysis. CONCLUSION The results indicated that CDKN2A SCNVs are associated with the prognosis of ESCdys and may serve as potential biomarkers for risk stratification.
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Affiliation(s)
- Zhiyuan Fan
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Jing Zhou
- Key Laboratory of Carcinogenesis and Translational Research (MOE/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yuan Tian
- Key Laboratory of Carcinogenesis and Translational Research (MOE/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Yu Qin
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhaojun Liu
- Key Laboratory of Carcinogenesis and Translational Research (MOE/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Liankun Gu
- Key Laboratory of Carcinogenesis and Translational Research (MOE/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
| | - Sanford M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Wenqiang Wei
- National Central Cancer Registry, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Dajun Deng
- Key Laboratory of Carcinogenesis and Translational Research (MOE/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
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Kalff MC, Dijksterhuis WPM, Wagner AD, Oertelt-Prigione S, Verhoeven RHA, Lemmens VEPP, van Laarhoven HWM, Gisbertz SS, van Berge Henegouwen MI. Sex differences in treatment allocation and survival of potentially curable gastroesophageal cancer: A population-based study. Eur J Cancer 2023; 187:114-123. [PMID: 37146505 DOI: 10.1016/j.ejca.2023.04.002] [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: 12/24/2022] [Revised: 03/31/2023] [Accepted: 04/04/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Although curative treatment options are identical for male and female gastroesophageal cancer patients, access to care and survival may vary. This study aimed to compare treatment allocation and survival between male and female patients with potentially curable gastroesophageal cancer. METHODS Nationwide cohort study including all patients with potentially curable gastroesophageal squamous cell or adenocarcinoma diagnosed between 2006 and 2018 registered in the Netherlands Cancer Registry. The main outcome, treatment allocation, was compared between male and female patients with oesophageal adenocarcinoma (EAC), oesophageal squamous cell carcinoma (ESCC), and gastric adenocarcinoma (GAC). Additionally, 5-year relative survival with relative excess risk (RER), that is, adjusted for the normal life expectancy, was compared. RESULTS Among 27,496 patients (68.8% men), most were allocated to curative treatment (62.8%), although rates dropped to 45.6%>70 years. Curative treatment rates were comparable among younger male and female patients (≤70 years) with gastroesophageal adenocarcinoma, while older females with EAC were less frequently allocated to curative treatment than males (OR = 0.85, 95% confidence interval [CI] 0.73-0.99). For those allocated to curative treatment, relative survival was superior for female patients with EAC (RER = 0.88, 95% CI 0.80-0.96) and ESCC (RER = 0.82, 95% CI 0.75-0.91), and comparable for males and females with GAC (RER = 1.02, 95% CI 0.94-1.11). CONCLUSIONS While curative treatment rates were comparable between younger male and female patients with gastroesophageal adenocarcinoma, treatment disparities were present between older patients. When treated, the survival of females with EAC and ESCC was superior to males. The treatment and survival gaps between male and female patients with gastroesophageal cancer warrant further exploration and could potentially improve treatment strategies and survival.
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Affiliation(s)
- Marianne C Kalff
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands.
| | - Willemieke P M Dijksterhuis
- Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands; Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Anna D Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands; Sex, and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany
| | - Rob H A Verhoeven
- Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands; Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands
| | - Valery E P P Lemmens
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands; Department of Public Health, Erasmus MC, Erasmus University, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands; Department of Medical Oncology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Suzanne S Gisbertz
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands
| | - Mark I van Berge Henegouwen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Cancer Center Amsterdam, de Boelelaan 1118, 1081 HV Amsterdam, The Netherlands.
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Shao Z, Li J, Liu Z, Bi S. Establishment and validation of systematic prognostic nomograms in patients over 60 years of age with osteosarcoma: A multicenter external verification study. Cancer Med 2023; 12:9589-9603. [PMID: 36992547 PMCID: PMC10166929 DOI: 10.1002/cam4.5736] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The aim of this study was to develop and validate systematic nomograms to predict cancer specific survival (CSS) and overall survival (OS) in osteosarcoma patients aged over 60 years. METHODS We used data from the Surveillance, Epidemiology, and End Results (SEER) database and identified 982 patients with osteosarcoma over 60 years of age diagnosed between 2004 and 2015. Overall, 306 patients met the requirements for the training group. Next, we enrolled 56 patients who met the study requirements from multiple medical centers as the external validation group to validate and analyze our model. We collected all available variables and finally selected eight that were statistically associated with CSS and OS through Cox regression analysis. Integrating the identified variables, we constructed 3- and 5-year OS and CSS nomograms, respectively, which were further evaluated by calculating the C-index. A calibration curve was used to evaluate the accuracy of the model. Receiver operating characteristic (ROC) curves measured the predictive capacity of the nomograms. The Kaplan-Meier analysis was used for all patient-based variables to explore the influence of various factors on patient survival. Finally, a decision curve analysis (DCA) curve was used to analyze whether our model would be suitable for application in clinical practice. RESULTS Cox regression analysis of clinical variables identified age, sex, marital status, tumor grade, tumor laterality, tumor size, M-stage, and surgical treatment as prognostic factors. Nomograms showed good predictive capacity for OS and CSS. We calculated that the C-index of the OS nomogram of the training population was 0.827 (95% CI 0.778-0.876), while that of the CSS nomogram was 0.722 (95% CI 0.665-0.779). The C-index of the OS nomogram evaluated on the external validation population was 0.716 (95% CI 0.575-0.857), while that of the CSS nomogram was 0.642 (95% CI 0.50-0.788). Furthermore, the calibration curve of our prediction models indicated the nomograms could accurately predict patient outcome. CONCLUSIONS The constructed nomogram is a useful tool for accurately predicting OS and CSS at 3 and 5 years for patients over 60 years of age with osteosarcoma and can assist clinicians in making appropriate decisions in practice.
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Affiliation(s)
- Zhuce Shao
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - JiaChen Li
- Department of Orthopaedics, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Ze Liu
- Shanxi Province Cancer Hospital, Taiyuan, China
| | - Shuxiong Bi
- Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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Krajc K, Miroševič Š, Sajovic J, Klemenc Ketiš Z, Spiegel D, Drevenšek G, Drevenšek M. Marital status and survival in cancer patients: A systematic review and meta-analysis. Cancer Med 2023; 12:1685-1708. [PMID: 35789072 PMCID: PMC9883406 DOI: 10.1002/cam4.5003] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND In recent years, authors have repeatedly reported on the significance of social support in cancer survival. Although overall the studies appear to be convincing, little is known about which types of social support promote better survival rates, and which subgroups of cancer patients are more susceptible to the benefits of it. The aim of this study was to identify, organize, and examine studies reporting on the significance of social support in cancer survival. METHODS The PubMed, CINAHL and EBSCO databases were searched using the keywords social support/marital status, cancer, and survival/mortality. Where possible we used a meta-analytical approach, specifically a random effect model, in order to combine the results of the hazard ratios in studies from which this information could be obtained. When interpreting clinical relevance, we used the number needed to treat (NNT). RESULTS Better survival was observed in married patients when compared to unmarried (single, never-married, divorced/separated, and widowed) in overall and cancer-specific survival. Gender group differences showed that the association was statistically significant only in cancer-specific survival when comparing divorced/separated male and female cancer patients (p < 0.001), thus confirming results from the previous meta-analysis. CONCLUSIONS Being unmarried is associated with significantly worse overall and cancer-specific survival. The most vulnerable group found in our study were divorced/separated men. The results of this review can motivate physicians, oncologists, and other healthcare professionals to be aware of the importance of patients' social support, especially in the identified sub-group.
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Affiliation(s)
- Kaja Krajc
- Faculty of Mathematics, Natural Sciences and Information TechnologiesUniversity of PrimorskaKoperSlovenia
| | - Špela Miroševič
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | - Jakob Sajovic
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
| | - Zalika Klemenc Ketiš
- Department of Family Medicine, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
- Department of Family Medicine, Faculty of MedicineUniversity of MariborMariborSlovenia
- Community Health Centre LjubljanaLjubljanaSlovenia
| | - David Spiegel
- Department of Psychiatry and Behavioural SciencesStanford University School of MedicineStanfordCaliforniaUSA
| | - Gorazd Drevenšek
- Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine LjubljanaUniversity of LjubljanaLjubljanaSlovenia
| | - Martina Drevenšek
- Department of StomatologyUniversity Medical Centre LjubljanaLjubljanaSlovenia
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Wen Y, Zhang H, Zhi K, Li M. Influence of marital status on the treatment and survival of middle-aged and elderly patients with primary bone cancer. Front Med (Lausanne) 2022; 9:1001522. [DOI: 10.3389/fmed.2022.1001522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe role of spousal support has been recognized to benefit patients with many chronic diseases and cancers. However, the impact of marital status on the survival of middle-aged and elderly patients with primary bone tumors remains elusive.Materials and methodsThe data of patients aged ≥ 45 years with primary bone tumors diagnosed between 2000 and 2018 were extracted from the Surveillance, Epidemiology, and End Results Database. Kaplan–Meier analysis was used to assess the overall survival and tumor-specific survival of patients. The Cox proportional hazards and Fine-and-Gray models were used to calculate the hazard ratios (HRs) and sub-distribution HRs (sHR) and the corresponding 95% confidence interval (CI) of all-cause mortality and tumor-specific mortality, respectively.ResultsA total of 5,640 primary bone tumors were included in the study. In 45–59 years cohort, married, unmarried, divorced and widowed accounted for 66.0, 21.0, 11.2, and 1.8%, respectively; while 64.3, 10.1, 8.8, and 16.8% in 60+ years cohort, respectively. The widowed patients had a lower proportion of early-stage tumors at diagnosis than that married, unmarried, and divorced patients (31.0% vs. 36% vs. 37.1% vs. 39.4%; P = 0.008), and had a higher proportion of patients who did not undergo surgery than that of married, unmarried, and divorced patients (38.6% vs. 21.3% vs. 24.6% vs. 24.4%; P < 0.001). The widowed population had an increased risk of all-cause mortality (HR, 1.68; 95% CI, 1.50–1.88; P < 0.001) and disease-related mortality (HR, 1.33; 95% CI, 1.09–1.61; P = 0.005) compared with the married population.ConclusionThe marital status of middle-aged and elderly people can affect the tumor stage at diagnosis, treatment, and survival prognosis of patients with primary bone cancer. Widowed patients are more inclined to choose non-surgical treatment and have the worst prognosis.
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Li L, Beeraka NM, Xie L, Dong L, Liu J, Wang L. Co-expression of High-mobility group box 1 protein (HMGB1) and receptor for advanced glycation end products (RAGE) in the prognosis of esophageal squamous cell carcinoma. Discov Oncol 2022; 13:64. [PMID: 35829833 PMCID: PMC9279518 DOI: 10.1007/s12672-022-00527-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/15/2022] [Indexed: 12/24/2022] Open
Abstract
Esophageal cancer is a malignant type of cancer with a high mortality rate. The aim of this study is to determine co-expression patterns of High-mobility group box 1 protein (HMGB1) and receptor for advanced glycation end products (RAGE) in ESCC (esophageal squamous cell carcinoma) conditions and their prognostic role in cancer progression. The expression of HMGB1 and RAGE in ESCC tissues has been analyzed using qRT-PCR and Western blotting. Co-localized expression patterns of HMGB1 and RAGE in ESCC tissues were determined using immunohistochemistry and analyzed for clinical-pathological parameters. Overall survival was performed based on co-expression of HMGB1 and RAGE proteins. A higher expression pattern of HMGB1, and RAGE was observed at mRNA and protein level in the ESCC group compared to the adjacent tissue group. Expression of HMGB1 was significantly correlated with lymph node, metastasis, lymphatic invasion, and venous invasion (p < 0.05). RAGE expression exhibited a significant correlation with venous invasion. Overall survival was significantly shorter (P < 0.05) in the patients with co-expression of HMGB1 and RAGE compared to the patients without co-expression. A significant difference in the overall survival was evident between the patients with co-expression of HMGB1 and RAGE and the patients without coexpression. HMGB1 and RAGE expression patterns were associated with aggressive metastatic characteristics of ESCC. The co-expression of HMGB1 and RAGE was correlated with shorter survival times. Results concluded the co-expression patterns of HMGB1 and RAGE exhibited a prognostic relevance in ESCC conditions.
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Affiliation(s)
- Lingzhao Li
- Department of Clinical Laboratory, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007 Henan People’s Republic of China
| | - Narasimha M. Beeraka
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan People’s Republic of China
- Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya Street, Moscow, 119991 Russian Federation
| | - Linsen Xie
- Department of Clinical Laboratory, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007 Henan People’s Republic of China
| | - Li Dong
- Department of Clinical Laboratory, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007 Henan People’s Republic of China
| | - Junqi Liu
- Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 Henan People’s Republic of China
| | - Lei Wang
- Department of Radiation Oncology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, 195# Tongbai Road, Zhengzhou, 450052 Henan People’s Republic of China
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Huang L, Peng S, Sun C, Chen L, Chu Q, Thapa S, Chummun V, Zhang L, Zhang P, Chen EL, Cheng C, Chen Y. Impact of marital status on survival in patients with stage 1A NSCLC. Aging (Albany NY) 2022; 14:770-779. [PMID: 35045398 PMCID: PMC8833113 DOI: 10.18632/aging.203838] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 09/18/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To study how marital status influences overall survival (OS) in patients with stage IA non-small cell lung cancer (NSCLC). And whether the result is valid in different time periods. MATERIALS AND METHODS We retrospectively analyzed 55,207 cases of stage IA NSCLC from 1995 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Marital status was classified as follows: married or with unmarried/domestic partner (MR/W.P), divorced or separated (DV/SP), widowed (WD), and single (never married). Patients diagnosed in 1995-2005 and 2006-2015 were analyzed separately as groups 1 and 2, respectively, to validate the results. Within each group, age-stratified demographic, clinicopathologic features, and OS were compared among different marital statuses. RESULTS AND CONCLUSIONS A total of 55,207 cases were included (group 1 n=20,223, group 2 n=34,984). From 1995-2005 to 2006-2015, median OS was prolonged significantly in all patients besides the DV/SP subgroup. In general, being MR/W.P was associated with the lowest relative risk of death in the study population (Group 1, HR= 0.854, 95%CI: 0.816-0.893; Group 2, HR = 0.799, 95%CI: 0.758-0.842). Meanwhile, OS of DV/SP and widowed patients was similar. In group 2, being single was associated with lower risk of death beyond 60-year-old.
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Affiliation(s)
- Liu Huang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Shu Peng
- Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Lian Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Sudip Thapa
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Vanisha Chummun
- Department of Radiotherapy and Oncology, Victoria Hospital, Candos, Quatre Bornes 72259, Mauritius
| | - Lu Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Peng Zhang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
| | - Eric L Chen
- AMITA Health Saint Joseph Hospital Chicago, Chicago, IL 60657, USA
| | - Ce Cheng
- The University of Arizona College of Medicine at South Campus, Tucson, AZ 85713, USA
| | - Yuan Chen
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, P.R. China
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Ho JK, Gui B, Yoon J, Zhang Q, Manne SL, Jabbour SK. Influence of Caregiver Presence During Physician Office Visits on Patients Undergoing Chemoradiation Therapy for Esophageal Cancer. Adv Radiat Oncol 2021; 6:100649. [PMID: 33912737 PMCID: PMC8071720 DOI: 10.1016/j.adro.2021.100649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
Purpose Although the association of marital status with outcomes for patients with cancer has been widely studied, the mechanisms underpinning the protective effect of marriage are still not fully understood. The social support that marriage imparts is often discussed as an explanation for why patients with cancer who are married have better outcomes. Social support has been difficult to objectively quantify. Accompaniment of the patient at physician visits may be more meaningful than marital status itself. This study investigated the effect of caregiver presence at physician visits on treatment tolerance and outcome in patients undergoing chemoradiation therapy (CRT) for esophageal cancer. Methods and Materials Patients who received a diagnosis of esophageal cancer who underwent CRT from January 1, 2005, to January 1, 2016, as part of their curative-intent management were retrospectively reviewed. Data collected included the patients’ marital status, caregiver presence at each physician visit, baseline performance status, serum albumin values and leukocyte values throughout treatment, patient weight values throughout treatment, tumor response to therapy, and overall survival. Patients were divided into 2 groups based on frequency of caregiver presence at physician visits (<50% or ≥50% of visits). Using χ2 tests, Wilcoxon rank sum tests, and log-rank tests, the patients’ characteristics, treatment tolerance and treatment outcome, and overall survival, respectively, were compared. Results In total, 35 of 59 patients were defined as having frequent caregiver presence at physician visits (≥50% of all documented visits), whereas 24 patients were categorized as having infrequent caregiver accompaniment. No significant difference in performance status or weight loss before the diagnosis of esophageal cancer was found. Patients who had frequent caregiver presence at physician visits maintained body weight better than those who had infrequent caregiver presence (median weight loss of 2.7 kg compared with 4.9 kg; P = .04). There was no difference in overall survival between the 2 groups. Conclusions Although patients with esophageal cancer undergoing CRT who had frequent caregiver presence at physician visits were not found to have an overall survival benefit, they had less weight loss, which may confer favorable treatment tolerance and maintenance of nutritional status during cancer treatment.
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Affiliation(s)
- Joseph K. Ho
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Bin Gui
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, New Jersey
| | - Jennifer Yoon
- Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey
| | - Quan Zhang
- First People’s Hospital of Huaian, Huaian, China
| | - Sharon L. Manne
- Rutgers Cancer Institute of New Jersey, Department of Population Science, New Brunswick, New Jersey
| | - Salma K. Jabbour
- Rutgers Cancer Institute of New Jersey, Department of Radiation Oncology, New Brunswick, New Jersey
- Corresponding author: Salma Jabbour, MD
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10
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Dijksterhuis WPM, Kalff MC, Wagner AD, Verhoeven RHA, Lemmens VEPP, van Oijen MGH, Gisbertz SS, van Berge Henegouwen MI, van Laarhoven HWM. Gender Differences in Treatment Allocation and Survival of Advanced Gastroesophageal Cancer: a Population-Based Study. J Natl Cancer Inst 2021; 113:1551-1560. [PMID: 33837791 PMCID: PMC8562959 DOI: 10.1093/jnci/djab075] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/01/2020] [Accepted: 04/07/2021] [Indexed: 12/12/2022] Open
Abstract
Background Biological sex and gender have been reported to affect incidence and overall survival (OS) of curatively treated gastroesophageal cancer. The aim of this study was to compare palliative treatment allocation and OS between women and men with advanced gastroesophageal cancer. Methods Patients with an unresectable or metastatic esophageal (including cardia) adenocarcinoma (EAC) or squamous cell carcinoma (ESCC) or gastric adenocarcinoma (GAC) diagnosed in 2015-2018 were identified in the Netherlands Cancer Registry. Treatment allocation was compared using χ2 tests and multivariable logistic regression analyses, and OS using the Kaplan-Meier method with log-rank test and Cox proportional hazards analysis. All statistical tests were 2-sided. Results Of patients with EAC (n = 3077), ESCC (n = 794), and GAC (n = 1836), 18.0%, 39.4%, and 39.1% were women, respectively. Women less often received systemic treatment compared with men for EAC (42.7% vs 47.4%, P = .045) and GAC (33.8% vs 38.8%, P = .03) but not for ESCC (33.2% vs 39.5%, P = .07). Women had a lower probability of receiving systemic treatment for GAC in multivariable analyses (odds ratio [OR] = 0.79, 95% confidence interval [CI] = 0.62 to 1.00) but not for EAC (OR = 0.86, 95% CI = 0.69 to 1.06) and ESCC (OR = 0.81, 95% CI = 0.57 to 1.14). Median OS was lower in women with EAC (4.4 vs 5.2 months, P = .04) but did not differ after adjustment for patient and tumor characteristics and systemic treatment administration. Conclusions We observed statistically significant and clinically relevant gender differences in systemic treatment administration and OS in advanced gastroesophageal cancer. Causes of these disparities may be sex based (ie, related to tumor biology) as well as gender based (eg, related to differences in treatment choices).
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Affiliation(s)
- Willemieke P M Dijksterhuis
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Marianne C Kalff
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Anna D Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Rob H A Verhoeven
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Valery E P P Lemmens
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus MC, Erasmus University, Rotterdam, The Netherlands
| | - Martijn G H van Oijen
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Suzanne S Gisbertz
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Mark I van Berge Henegouwen
- Amsterdam UMC, University of Amsterdam, Department of Surgery, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Hanneke W M van Laarhoven
- Amsterdam UMC, University of Amsterdam, Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam, The Netherlands
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11
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Abstract
Background: This study aimed to develop nomograms predicting the overall survival (OS) of patients younger than 50 years old with esophageal cancer.Methods: We selected patients included 2004-2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed using significant variables from multivariable Cox analyses. The discrimination and calibration power of the models were evaluated using concordance indexes (C-indexes) and calibration curves. Decision curve analysis was used to assess the clinical net benefits of the nomograms.Results: Of 1,997 selected patients, 53.2% had advanced-stage tumor. Race, grade, T stage, N stage, and treatment were independent factors affecting OS in early-stage patients. The C-indexes of the corresponding nomogram were 0.710 (95% CI = 0.684-0.736) and 0.681 (95% CI = 0.640-0.722) in training and validation sets, respectively. Grade, marital status, and treatment were independent factors affecting OS in advanced-stage patients. The C-indexes of the corresponding nomogram were 0.677 (95% CI = 0.653-0.701) and 0.675 (95% CI = 0.638-0.712) in training and validation sets, respectively. Calibration curves demonstrated high consistency between predicted and actual survival.Conclusion: We constructed and verified nomograms that could accurately predict the survival rate of esophageal cancer in patients younger than 50 years old. This may help clinicians better understand prognostic factors.
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Affiliation(s)
- Min Shi
- Department of Gastroenterology, Liyang People's Hospital, Liyang, China
| | - Jian-Wei Tang
- Department of Gastroenterology, Liyang People's Hospital, Liyang, China
| | - Zhi-Rong Cao
- Department of Gastroenterology, Liyang People's Hospital, Liyang, China
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12
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Duorui N, Shi B, Zhang T, Chen C, Fang C, Yue Z, Wu P, Wu Z, Huang X, Li M. The contemporary trend in worsening prognosis of pancreatic acinar cell carcinoma: A population-based study. PLoS One 2020; 15:e0243164. [PMID: 33332471 PMCID: PMC7746196 DOI: 10.1371/journal.pone.0243164] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/14/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Primary acinar cell carcinoma (ACC) is a rare exocrine tumor of the pancreas with unclear clinical characteristics. Our goal was to determine the incidence and update the clinical characteristics and outcomes of ACC. METHODS Through the Surveillance, Epidemiology, and End Results (SEER) database, we identified 252 patients with the latest diagnosis of ACC (2004-2016). The age-adjusted incidence (AAI) was calculated using the SEER*Stat Software version 8.3.6. The Kaplan-Meier method was used to draw survival curves and differences among them were compared by the log-rank test. Cox proportional hazards models were used to evaluate factors that had independent predictive effects on the overall survival. RESULTS The AAI of pancreatic ACC was on the rise with the mean age at diagnosis of 63.79±14.79 years. Most patients (15.9%) had poorer differentiated tumors. The patients presented with distant stage were 54.4% compared with 53.1% between 1988 and 2003. The 1-, 2-, and 5-years survival rates for pancreatic ACC patients were 53.5%, 34.6%,17.5%, respectively (compared with 78.5%, 67.0%, and 42.8%, between 1988 and 2003). The multivariate COX analysis showed that the patient's age, surgery, chemotherapy, and summary stage, but not marital status were independent prognosis factors for ACC. CONCLUSIONS Pancreatic ACC is a highly malignant tumor with an increasing incidence in recent years. The rate of distant metastasis is increasing and the survival rate is worse than in the past, suggesting that it may require more aggressive treatment and follow-up. Surgery, radiotherapy, and chemotherapy are all effective treatments, but prospective studies are still needed to verify them.
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Affiliation(s)
- Nie Duorui
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bin Shi
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Tao Zhang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chuyao Chen
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Chongkai Fang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhijun Yue
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Peng Wu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhiming Wu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xuewu Huang
- Cancer center, Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital, Guangzhou, Guangdong, China
| | - Meng Li
- Department of Oncology, Shenzhen Hospital (Futian) of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
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13
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He Y, Liang D, Du L, Guo T, Liu Y, Sun X, Wang N, Zhang M, Wei K, Shan B, Chen W. Clinical characteristics and survival of 5283 esophageal cancer patients: A multicenter study from eighteen hospitals across six regions in China. Cancer Commun (Lond) 2020; 40:531-544. [PMID: 32845581 PMCID: PMC7571391 DOI: 10.1002/cac2.12087] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/06/2020] [Indexed: 12/13/2022] Open
Abstract
Objective This study aimed to investigate the potential determining epidemiological and clinical risk factors affecting the survival of esophageal cancer (EC) patients across multiple hospitals in China. Methods This was a multicenter study comprising of newly diagnosed EC cases from Beijing, Hebei, Henan, Hubei, Zhejiang, and Guangdong Province of China. Their baseline characteristics and treatment methods data were collected from their medical records. The EpiData software was used for data quality control. The Kaplan‐Meier method was used to estimate their overall survival (OS), and the Cox's proportional hazard regression model was used to estimate hazard ratios (HR) and 95% confidence interval (CI). Results The 3‐ and 5‐year OS rates of the 5283 investigated EC patients were 49.98% and 39.07%, respectively. Their median survival was 36.00 months. The median survival time of females was longer than that of males (females vs. males: 45.00 vs. 33.00, P < 0.001). The 5‐year OS rate of patients who never‐smoked was higher than that of smokers (never‐smokers vs smokers: 40.73% vs. 37.84%, P = 0.001). There was no significant difference in the 5‐year OS rate between drinkers and never‐drinkers (drinkers vs never‐drinkers: 34.22% vs. 29.65%, P = 0.330). In multivariate analysis, pathological stage (stage II: HR = 1.80, 95% CI = 1.40‐2.31; stage III: HR = 2.62, 95% CI = 2.06‐3.34; stage IV: HR = 3.90, 95% CI = 2.98‐5.09), poor differentiation/undifferentiated (HR = 1.34, 95% CI = 1.11‐1.63), not married status (HR = 2.45, 95% CI = 1.49‐4.04), production and service personnel (HR = 1.36, 95% CI = 1.01‐1.83) and farming/fishing (HR = 1.40, 95% CI = 1.12‐1.76) were independent prognostic risk factors for poor EC survival. Tumors in the thoracic or abdominal part of the esophagus, female and family history of any cancer were independent factors predictive of a good EC OS. Conclusion Gender, marital status, occupation, family history of any cancer, tumor topographical site, differentiation status, and pathological stage were associated with the survival rate of EC. This study reveals important clinical characteristics of esophageal cancer patients in China and provides helpful information for their clinical management and surveillance.
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Affiliation(s)
- Yutong He
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, P. R. China
| | - Di Liang
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, P. R. China
| | - Lingbin Du
- Zhejiang Cancer Center, Hangzhou, Zhejiang, 310000, P. R. China
| | - Tiantian Guo
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, P. R. China
| | - Yanyu Liu
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, P. R. China
| | - Xibin Sun
- Henan Cancer Hospital, Zhengzhou, Henan, 450000, P. R. China
| | - Ning Wang
- Beijing Cancer Hospital, Beijing, 100021, P. R. China
| | - Min Zhang
- Hubei Cancer Hospital, Wuhan, Hubei, 430000, P. R. China
| | - Kuangrong Wei
- Zhongshan Cancer Hospital, Zhongshan, Guangdong, 528400, P. R. China
| | - Baoen Shan
- Cancer Institute, the Fourth Hospital of Hebei Medical University/the Tumor Hospital of Hebei Province, Shijiazhuang, Hebei, 050000, P. R. China
| | - Wanqing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, 100021, P. R. China
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14
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Abstract
OBJECTIVE To improve understanding of sex differences in clinicopathologic characteristics, treatment and outcomes between male and female patients undergoing esophagectomy for esophageal cancer. SUMMARY BACKGROUND DATA Esophageal cancer is a male predominant disease, and sex has not been considered in previous studies as an important factor in diagnosis or management. Sex differences in demographics, clinicopathologic characteristics, and postoperative outcomes remain largely undefined. METHODS Retrospective review of 1958 patients (21% female) with esophageal cancer who underwent esophagectomy at a single institution between 1995 and 2017. RESULTS Most patients had adenocarcinoma (83%); however, the rate of squamous cell carcinoma was significantly higher in females (35% vs 11%, respectively; P < .0001). Females had a lower rate of smoking (62 vs 73%) and heavy alcohol use (12 vs 19%) but a higher rate of previous mediastinal radiation (8.4 vs 1.8%) (P < 0.001). Postoperative mortality and overall survival (OS) were similar between sexes. However, subanalysis of patients with locoregional disease (clinical stage II/III) demonstrated that females received neoadjuvant therapy less frequently than males and had worse OS (median OS 2.56 yrs vs 2.08; P = 0.034). This difference remained significant on adjusted analysis (HR 1.24, 95% CI 1.06-1.46). CONCLUSIONS Female patients had higher incidence of squamous cell carcinoma despite lower prevalence of behavioral risk factors. Among patients with locoregional disease, undertreatment in females may reflect treatment bias and history of previous mediastinal radiation. Esophageal cancer in females should be considered a unique entity as compared with the presentation and treatment of males.
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15
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Paniagua Cruz A, Haug KL, Zhao L, Reddy RM. Association Between Marital Status and Racial Disparities in Esophageal Cancer Care. JCO Oncol Pract 2020; 16:e498-e506. [PMID: 32369408 DOI: 10.1200/jop.19.00561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE This study was designed to examine the impact of marital status on racial disparities in esophageal cancer care. PATIENTS AND METHODS We performed a secondary analysis of data collected from the state cancer registry maintained by the Michigan Department of Health and Human Services. We identified patients with an esophageal cancer diagnosis between January 1, 2000, and December 31, 2013. χ2 test and logistics regression were used to analyze 6,809 patients who met our eligibility criteria. Statistical significance was defined as P ≤ .05. RESULTS Approximately 88.4% of our patients were White and 11.6% were Black. A significantly higher number of White patients were married when compared with Blacks (62.9% v 31.8%, respectively; P < .0001). There was no significant difference in cancer staging between the 2 groups (P = .0671). Married Blacks had similar rates of esophagectomy, chemotherapy, and radiation as married Whites. Both single groups had lower rates of esophagectomy and chemotherapy than married Whites, but single Blacks were the least likely to undergo esophagectomy. Single patients were more likely to refuse treatment. CONCLUSION Marital status differs significantly in Black and White patients with esophageal cancer and may help explain racial disparities in cancer care. Further research is needed to explore reasons for care underutilization in single patients and whether these differences translate into clinical outcomes.
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Affiliation(s)
| | - Karlie L Haug
- Department of Surgery, University of Wisconsin, Madison, WI
| | - Lili Zhao
- University of Michigan School of Public Health, Ann Arbor, MI
| | - Rishindra M Reddy
- University of Michigan Medical School, Ann Arbor, MI.,Department of Surgery, Section of Thoracic Surgery, University of Michigan, Ann Arbor, MI
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16
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Deng J, Chu X, Ren Z, Wang B. Relationship between T stage and survival in distantly metastatic esophageal cancer: A STROBE-compliant study. Medicine (Baltimore) 2020; 99:e20064. [PMID: 32384472 PMCID: PMC7220676 DOI: 10.1097/md.0000000000020064] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
To shed light on the interaction between the American Joint Committee on Cancer (AJCC) T stage and M stage in the determination of the overall survival (OS) and cancer-specific survival (CSS) of esophageal carcinoma patients. Moreover, to confirm our hypothesis that tumors that metastasize to distant sites in the early T stage may reflect a more biologically aggressive disease compared with those that metastasize in more advanced T stages.We performed a retrospective cohort study with patients who were pathologically diagnosed with esophageal cancer between 2004 and 2014 in the surveillance epidemiology and end results (SEER) database. The primary study variables were the T and M stage, as well as their interaction terms. We performed a survival analysis of the interaction terms using unadjusted Kaplan-Meier methods and adjusted Cox proportional hazards models. Furthermore, we performed an exploratory analysis with stratification by histological type, esophageal adenocarcinoma (EAC), and esophageal squamous cell carcinoma (ESCC).Data of 19,078 patients were retrieved from the SEER database. Unadjusted Kaplan-Meier curve indicated that patients with T2 and T3 stage had longer median OS and CSS (3 months and 4 months, respectively) than with T1 stage in distantly metastatic esophageal cancer (M1 stage). Multivariate analysis revealed a significant interaction between the T stage and M stage when determining the OS and CSS of esophageal cancer (P < .001). Using T1M0 as a reference, patients with T1M1 had significantly worse OS and CSS than those with T2M1 and T3M1 stage (P < .001). A similar pattern was also observed among patients with EAC and ESCC.Our analysis suggests that the T1 stage predicts worse survival compared with T2 and T3 stage in distantly metastatic esophageal cancer and might be a surrogate for biologically aggressive disease, indicating that those patients should receive more aggressive treatments. Our findings also encourage researchers to discover new genomic changes in this subset of tumors with the potential to uncover new prognostic markers or drug targets. Further researches on the association between T stage and survival in metastatic esophageal cancer are warranted to validate our findings.
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17
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Islam MS, Jahangir CA, Rahi MS, Hasan MM, Sajib SA, Hoque KMF, Reza MA. In-vivo antiproliferative activity of Morus latifolia leaf and bark extracts against Ehrlich's ascites carcinoma. Toxicol Res 2020; 36:79-88. [PMID: 31998627 PMCID: PMC6988622 DOI: 10.1007/s43188-019-00011-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/06/2019] [Accepted: 04/25/2019] [Indexed: 01/17/2023] Open
Abstract
Cancer is the second death causing disease all over the world and until today 100 different types of cancer have been identified whose treatment methods consist of serious side effects on human body. To reduce the frequency of adverse effects of cancer treatment, nowadays plant derived natural components are getting priority. The plant Morus latifolia is widely available in northern part of Bangladesh. The earlier researches suggested that popular varieties of some Morus sp. like Morus alba, Morus indica etc. have good anti-proliferative activity. Hence, this study was designed to evaluate the anti-proliferative activity of leaf and bark extracts of M. latifolia against Ehrlich's ascites carcinoma (EAC) in vivo. The leaf and bark extracts of M. latifolia were used in several bioassays including Brine shrimp lethality test, hemagglutination activity test, antioxidant activity test, and cell growth inhibition test. Besides, fluorescence microscopy was performed to study apoptotic features in EAC cells, and molecular analysis like real-time PCR were also conducted. The results of Brine shrimp lethality test, hemagglutination activity test, and antioxidant activity assay supported the cell growth inhibition capability of leaf and bark extracts which was confirmed by in vivo cell growth inhibition bioassay. Moreover, the experimental extracts were able to induce cell apoptotis through altering the expression pattern of Bcl-2 and Bax genes. All of the results of this study suggest that several noble compounds are present in M. latifolia plant extracts which are capable for healing cancer cells.
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Affiliation(s)
- Md. Shihabul Islam
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Chowdhury Arif Jahangir
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Md. Sifat Rahi
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Md. Mahmudul Hasan
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Salek Ahmed Sajib
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Kazi Md. Faisal Hoque
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
| | - Md Abu Reza
- Molecular Biology and Protein Science Laboratory, Department of Genetic Engineering and Biotechnology, Faculty of Life and Earth Science, University of Rajshahi, Rajshahi, 6205 Bangladesh
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18
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Zhang J, Ma W, Wu H, Wang J, Lin Y, Wang X, Zhang C. Analysis of Homogeneous and Heterogeneous Factors for Bone Metastasis in Esophageal Cancer. Med Sci Monit 2019; 25:9416-9425. [PMID: 31821313 PMCID: PMC6924131 DOI: 10.12659/msm.920483] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Esophageal cancer is a common cancer worldwide. We performed the present study to assess the homogeneous and heterogeneous risk and prognostic factors of bone metastasis (BM) in esophageal cancer patients using data extracted from the Surveillance, Epidemiology, and End Results (SEER) database. MATERIAL AND METHODS Data from patients with esophageal cancer in the SEER database from 2010 to 2016 were extracted to reveal the risk factors for BM through univariable and multivariable logistic regression. Cox hazard regression analysis was used to evaluate the prognostic factors in esophageal cancer patients with BM from 2010 to 2015. RESULTS A total of 2075 (8.0%) patients with initial bone metastasis were diagnosed from among 25 955 patients with esophageal cancer from 2010 to 2016. Male sex, T4 stage, brain metastasis, and liver metastasis were common risk factors for the occurrence and prognosis of BM. Patients with age younger than 67 years, grade III, higher N stage (N1, N2, and N3), histological subtype of esophageal adenocarcinoma or others, and lung metastasis were also more likely to experience bone metastasis, while unmarried patients were associated with shorter survival. CONCLUSIONS The prevalence of initial bone metastasis was approximately 8.0% in esophageal cancer patients. More attention should be paid to patients with revealed risk and prognostic factors because these factors can guide individualize bone metastasis screening and treatment of esophageal cancer patients.
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Affiliation(s)
- Jin Zhang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland)
| | - Wenjuan Ma
- Department of Breast Imaging, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland)
| | - Haixiao Wu
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland)
| | - Jun Wang
- Department of Oncology, Radiology and Nuclear Medicine, Medical Institute of Peoples' Friendship University of Russia, Moscow, Russian Federation
| | - Yile Lin
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland)
| | - Xin Wang
- Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, Chongqing, China (mainland)
| | - Chao Zhang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland)
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19
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Qiu S, Tao L, Zhu Y. Marital Status and Survival in Osteosarcoma Patients: An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Database. Med Sci Monit 2019; 25:8190-8203. [PMID: 31672959 PMCID: PMC6849371 DOI: 10.12659/msm.918048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background As the most malignant bone tumor globally, osteosarcoma has drawn increased attention. However, no studies have focused on the association between marital status and survival rate. The objectives of this study were to determine the association between marital and survival rate of osteosarcoma patients based on the SEER database. Material/Methods We enrolled a total of 2725 osteosarcoma patients between 1973 and 2015, including 1184 married, 154 divorced/separated, 136 widowed, and 1251 never-married patients. Survival rate was determined based on the Kaplan-Meier method in different marital subgroups. Multivariate Cox regression analysis was performed to explore independent prognostic factors. Results The 5-year overall survival (OS) and cancer-specific survival (CSS) rates of the married, separated/divorced, widowed, and never-married subjects were 45.93%, 41.39%, 19.08%, and 57.21% (OS), and 49.97%, 45.85%, 22.14%, and 60.69% (CSS), respectively. The survival outcome among subgroups exhibited a clear difference, with a log-rank test p-value <0.0001. Multivariate Cox regression showed that widowhood served as the independent prognostic factor for decreased OS rather than marriage (HR, 1.246; 95% CI, 1.011–1.536; p-value=0.039) and CSS (HR, 1.34; 95% CI, 1.07–1.68; p-value=0.01). Moreover, the OS and CSS in widowed patients were lower. Additionally, based on the propensity score matching (PSM) method, the prognosis of married patients was better than that of unmarried subjects. Conclusions Marital status was correlated with the survival rate, meaning that married patients had higher survival than widowed subjects, who had worse prognoses of osteosarcoma.
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Affiliation(s)
- Shui Qiu
- Department of Orthopaedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Lin Tao
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yue Zhu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
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20
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Zhang G, Wu B, Wang X, Li J. Second primary malignancy in patients with esophageal adenocarcinoma and squamous cell carcinoma. Medicine (Baltimore) 2019; 98:e17083. [PMID: 31490413 PMCID: PMC6738979 DOI: 10.1097/md.0000000000017083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
There have been no studies on implementing effective screening models for esophageal adenocarcinoma and squamous cell carcinoma survivors. We used a proportional subdistribution hazards model to estimate second primary malignancy risks among patients with esophageal adenocarcinoma and squamous cell carcinoma. We validated models using a bootstrap cross-validation method and performed decision curve analysis to evaluate their clinical utility. Age group and SEER historic stage were significantly associated with second primary malignancy risk after diagnosis of esophageal adenocarcinoma and squamous cell carcinoma. Saving positive lymph nodes and distant metastasis were significant factors in the adenocarcinoma group, and marital status, tumor location, and chemotherapy were significant factors in the squamous cell carcinoma group. Calibration plots show good concordance between predicted and actual outcomes except in high-probability areas for the risk of a second primary malignancy in patients with esophageal squamous cell carcinoma. Discrimination performances of the Fine-Gray models were evaluated using c-indices, which were 0.691 and 0.662 for second primary malignancies in patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively. Decision curve analysis yielded a range of threshold probabilities (0.020-0.177 and 0.021-0.133 for patients with esophageal adenocarcinoma and squamous cell carcinoma, respectively) at which the clinical net benefit of the risk model was larger than those of hypothetical all-screening and no-screening scenarios. Our nomograms enable selection of patient populations at high risk for a second primary malignancy and thus will facilitate the design of prevention trials for affected populations.
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Liu M, Wang C, Gao L, Lv C, Cai X. A nomogram to predict long-time survival for patients with M1 diseases of esophageal cancer. J Cancer 2018; 9:3986-3990. [PMID: 30410603 PMCID: PMC6218766 DOI: 10.7150/jca.27579] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 08/19/2018] [Indexed: 11/12/2022] Open
Abstract
Objective: To evaluate the clinicopathologic characteristics of the long-time survivals and construct a clinical nomogram using the Surveilance, Epidemiology, and End Results (SEER) database. Materials and Methods: Information of patients diagnosed with M1 stage esophageal cancer from 2010-2014 was retrieved from SEER database. Patients with unknown information of AJCC TNM stage or metastatic sites or marital status or surgery or survival were excluded. Demographic and clinicopathologic characteristics were compared between LTS (long time survivals: patients who have survived for no less than 2 years) and STS (shorter time survivals: patients who have survived for less than 2 years). Cox regression analysis was performed to evaluate prognostic factors. A nomogram comprising demographic and clinicopathologic factors was established to predict 1-year survival and 2-year survival for patients with M1 diseases. Results: A total of 2981 patients from the SEER database were included for analysis. Compared with the STS, married people and patients with well differentiated tumors or oligometastatic site were more likely to be LTS. Also, LTS were associated with significantly less bone metastasis and more surgery. The OS nomogram, which had a c-index of 0.633, was based on the eleven variables: gender, age, marital status, T stage, N stage, histology, grade, number of important metastatic organs and primary surgery. Conclusions: Married patients, patients with well differentiated tumors, patients with oligometastatic site, patients without bone metastasis or liver metastasis and those who underwent surgery are associated with long time survivals. We developed a nomogram predicting 1- and 2-year OS and CSS for M1 stage esophageal cancer. The prognostic model may improve clinicians' abilities to predict individualized survival and to make treatment recommendations.
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Affiliation(s)
- Mina Liu
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University. 241 West Huaihai Road, Shanghai, 200030, China
| | - Changlu Wang
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University. 241 West Huaihai Road, Shanghai, 200030, China
| | - Lanting Gao
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University. 241 West Huaihai Road, Shanghai, 200030, China
| | - Changxing Lv
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University. 241 West Huaihai Road, Shanghai, 200030, China
| | - Xuwei Cai
- Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University. 241 West Huaihai Road, Shanghai, 200030, China
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