1
|
Wu Y, Walker EV, Yuan Y. Regional Variability in Survival for Patients Diagnosed with Selected Central Nervous System Tumours in Canada. Curr Oncol 2024; 31:3073-3085. [PMID: 38920718 PMCID: PMC11203179 DOI: 10.3390/curroncol31060234] [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: 04/17/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Canada's decentralized healthcare system may lead to regional disparities in survival among Canadians diagnosed with central nervous system (CNS) tumours. We identified 50,670 patients diagnosed with a first-ever primary CNS tumour between 2008 and 2017 with follow-up until 31 December 2017. We selected the four highest incidence histologies and used proportional hazard regression to estimate hazard ratios (HRs) for five regions (British Columbia, Prairie Provinces, Ontario, Atlantic Provinces and the Territories), adjusting for sex, tumour behaviour and patient age. Ontario had the best survival profile for all histologies investigated. The Atlantic Provinces had the highest HR for glioblastoma (HR = 1.26, 95% CI: 1.18-1.35) and malignant glioma not otherwise specified (NOS) (Overall: HR = 1.87, 95% CI:1.43-2.43; Pediatric population: HR = 2.86, 95% CI: 1.28-6.39). For meningioma, the Territories had the highest HR (HR = 2.44, 95% CI: 1.09-5.45) followed by the Prairie Provinces (HR = 1.52, 95% CI: 1.38-1.67). For malignant unclassified tumours, the highest HRs were in British Columbia (HR = 1.45, 95% CI: 1.22-1.71) and the Atlantic Provinces (HR = 1.40, 95% CI: 1.13-1.74). There are regional differences in the survival of CNS patients at the population level for all four specific histological types of CNS tumours investigated. Factors contributing to these observed regional survival differences are unknown and warrant further investigation.
Collapse
Affiliation(s)
- Yifan Wu
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (Y.W.); (E.V.W.)
| | - Emily V. Walker
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (Y.W.); (E.V.W.)
- Precision Analytics, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3C6, Canada
| | - Yan Yuan
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (Y.W.); (E.V.W.)
| |
Collapse
|
2
|
Palmer JD, Chavez G, Furnback W, Chuang PY, Wang B, Proescholdt C, Tang CH. Health-Related Quality of Life for Patients Receiving Tumor Treating Fields for Glioblastoma. Front Oncol 2021; 11:772261. [PMID: 34926281 PMCID: PMC8675863 DOI: 10.3389/fonc.2021.772261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background To date, there has been no large-scale, real-world study of the health-related quality of life outcomes for patients using tumor treating fields (TTFields) therapy for glioblastoma (GBM) treatment. Methods A survey was mailed to 2,815 patients actively using TTFields for treatment of GBM in the USA (n = 2,182) and Europe (n = 633). The survey included patient-reported demographic and clinical information, as well as EuroQol’s EQ-5D-5L and visual analogue scale (EQ-VAS) overall health score. Results A total of 1,106 applicable patients responded to the survey (USA = 782 and Europe = 324), with a mean age of 58.6 years (SD = 12.3). The average time since diagnosis and time using TTFields were 21.5 months (SD = 25.1) and 13.5 months (SD = 13.2), respectively. Over 61% of patients had been diagnosed at least 1 year prior and 28.4% at least 2 years prior; 45 patients (4.2%) had been diagnosed at least 5 years prior. Progressed disease was reported in 307 patients, while 690 reported non-progressed disease. Regression analyses showed that GBM disease progression and older age had predictable negative associations (p < 0.001) with most EQ-5D-5L dimensions and the EQ-VAS. However, longer time since diagnosis was associated with improved self-care (p < 0.05), usual activities (p < 0.01), and EQ-VAS (p < 0.05) overall and in patients with progressed disease (p < 0.01, p < 0.05, and p < 0.01, respectively). Additionally, longer time using TTFields was associated with improved mobility (p < 0.05), self-care (p < 0.001), usual activities (p < 0.01), and EQ-VAS (p < 0.01) overall; with improved EQ-VAS in progression-free patients (p < 0.05); and with improved mobility (p < 0.05), self-care (p < 0.01), usual activities (p < 0.05), and EQ-VAS (p < 0.05) in patients with progressed disease. Conclusion This is the largest real-world study of patient-reported quality of life in GBM and TTFields treatment to date. It shows unsurprising negative associations between quality of life and disease progression and older age, as well as more novel, positive associations between quality of life and longer time since diagnosis and time using TTFields therapy.
Collapse
Affiliation(s)
- Joshua D Palmer
- The James Cancer Hospital and Solove Research Institute at the Ohio State University, Columbus, OH, United States
| | - Gordon Chavez
- Department of Global Value, Novocure, New York, NY, United States
| | - Wesley Furnback
- Department of Value and Access, Real Chemistry, New York, NY, United States
| | - Po-Ya Chuang
- Department of Value and Access, Real Chemistry, New York, NY, United States
| | - Bruce Wang
- Department of Value and Access, Real Chemistry, New York, NY, United States
| | | | - Chao-Hsiun Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
3
|
Touati S, Djekkoun R, El-Okki MEH, Satta D. Epidemiology and survival analyses of 333 adult glioma patients from Eastern Algeria (2008-2016). Afr Health Sci 2020; 20:1250-1258. [PMID: 33402972 PMCID: PMC7751532 DOI: 10.4314/ahs.v20i3.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Gliomas are a relatively rare group of tumors with a poor prognosis. We aimed to describe and analyze the clinical characteristics and survival of patients with glioma tumors of Eastern Algeria. METHODS A retrospective study was conducted at the University Hospital of Constantine. Medical records of patients enrolled between January 2008 and October 2016 were consulted. Demographic characteristics, clinical data, treatment strategy and dates of last follow-up or death were collected. Chi-square test was used for checking associations, Kaplan-Meier methodology for estimating the survival, and the cox model for identifying prognosis factors. RESULTS A total of 333 patients composed our cohort. The mean age was 48.07 years, and men were 1.87 times more frequent than women. High grade tumors were mainly observed among adults and old adults and in supra-tentorial locations. More than half of the patients had a large resection and a curative protocol of oncological treatment (50.7% and 57%, respectively). The mean overall survival was 45.4 months, the median was 21.7 months, and survival rates at 1-, 2-, and 5-years were: 62.8%, 48.5% and 32.9% respectively. Age, histology, grade of malignancy and oncological treatment were the major prognosis factors. CONCLUSION Our sample was relatively young with a higher survival compared to others.
Collapse
Affiliation(s)
- Sabrina Touati
- Laboratory of molecular and cellular biology, Mentouri Brothers University, Constantine, Algeria
| | - Rachid Djekkoun
- Radiation-Oncology Department, University Hospital Benbadis, Constantine, Algeria
- Occupational hazards and health laboratory, Salah Boubnider University, Constantine, Algeria
| | | | - Dalila Satta
- Laboratory of molecular and cellular biology, Mentouri Brothers University, Constantine, Algeria
| |
Collapse
|
4
|
Latenstein AEJ, van Roessel S, van der Geest LGM, Bonsing BA, Dejong CHC, Groot Koerkamp B, de Hingh IHJT, Homs MYV, Klaase JM, Lemmens V, Molenaar IQ, Steyerberg EW, Stommel MWJ, Busch OR, van Eijck CHJ, van Laarhoven HWM, Wilmink JW, Besselink MG. Conditional Survival After Resection for Pancreatic Cancer: A Population-Based Study and Prediction Model. Ann Surg Oncol 2020; 27:2516-2524. [PMID: 32052299 PMCID: PMC7311496 DOI: 10.1245/s10434-020-08235-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Indexed: 12/12/2022]
Abstract
Background Conditional survival is the survival probability after already surviving a predefined time period. This may be informative during follow-up, especially when adjusted for tumor characteristics. Such prediction models for patients with resected pancreatic cancer are lacking and therefore conditional survival was assessed and a nomogram predicting 5-year survival at a predefined period after resection of pancreatic cancer was developed. Methods This population-based study included patients with resected pancreatic ductal adenocarcinoma from the Netherlands Cancer Registry (2005–2016). Conditional survival was calculated as the median, and the probability of surviving up to 8 years in patients who already survived 0–5 years after resection was calculated using the Kaplan–Meier method. A prediction model was constructed. Results Overall, 3082 patients were included, with a median age of 67 years. Median overall survival was 18 months (95% confidence interval 17–18 months), with a 5-year survival of 15%. The 1-year conditional survival (i.e. probability of surviving the next year) increased from 55 to 74 to 86% at 1, 3, and 5 years after surgery, respectively, while the median overall survival increased from 15 to 40 to 64 months at 1, 3, and 5 years after surgery, respectively. The prediction model demonstrated that the probability of achieving 5-year survival at 1 year after surgery varied from 1 to 58% depending on patient and tumor characteristics. Conclusions This population-based study showed that 1-year conditional survival was 55% 1 year after resection and 74% 3 years after resection in patients with pancreatic cancer. The prediction model is available via www.pancreascalculator.com to inform patients and caregivers. Electronic supplementary material The online version of this article (10.1245/s10434-020-08235-w) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anouk E J Latenstein
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Stijn van Roessel
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lydia G M van der Geest
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Bert A Bonsing
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Cornelis H C Dejong
- Department of Surgery, Maastricht University Medical Centre and NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Bas Groot Koerkamp
- Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Marjolein Y V Homs
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Joost M Klaase
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Valery Lemmens
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - I Quintus Molenaar
- Department of Surgery, Regional Academic Cancer Center Utrecht, St Antonius Hospital Nieuwegein and University Medical Center Utrecht Cancer Center, Utrecht, The Netherlands
| | | | - Martijn W J Stommel
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olivier R Busch
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Hanneke W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna W Wilmink
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marc G Besselink
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | | |
Collapse
|