1
|
Zhang S, Cheng T. Prognostic and clinicopathological value of systemic inflammation response index (SIRI) in patients with breast cancer: a meta-analysis. Ann Med 2024; 56:2337729. [PMID: 38569199 PMCID: PMC10993763 DOI: 10.1080/07853890.2024.2337729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/09/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Many studies have explored the value of the systemic inflammation response index (SIRI) in predicting the prognosis of patients with breast cancer (BC); however, their findings remain controversial. Consequently, we performed the present meta-analysis to accurately identify the role of SIRI in predicting BC prognosis. METHODS PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched between their inception and February 10, 2024. The significance of SIRI in predicting overall survival (OS) and disease-free survival (DFS) in BC patients was analyzed by calculating pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). RESULTS Eight articles involving 2,997 patients with BC were enrolled in the present study. According to our combined analysis, a higher SIRI was markedly associated with dismal OS (HR = 2.43, 95%CI = 1.42-4.15, p < 0.001) but not poor DFS (HR = 2.59, 95%CI = 0.81-8.24, p = 0.107) in patients with BC. Moreover, based on the pooled results, a high SIRI was significantly related to T3-T4 stage (OR = 1.73, 95%CI = 1.40-2.14, p < 0.001), N1-N3 stage (OR = 1.61, 95%CI = 1.37-1.91, p < 0.001), TNM stage III (OR = 1.63, 95%CI = 1.34-1.98, p < 0.001), and poor differentiation (OR = 1.25, 95%CI = 1.02-1.52, p = 0.028). CONCLUSION According to our results, a high SIRI significantly predicted poor OS in patients with BC. Furthermore, elevated SIRI was also remarkably related to increased tumor size and later BC tumor stage. The SIRI can serve as a novel prognostic biomarker for patients with BC.
Collapse
Affiliation(s)
- Sunhuan Zhang
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China
| | - Tongtong Cheng
- Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, Zhejiang, China
| |
Collapse
|
2
|
Li Q, Ai L, Zuo L, Li J, Zhao F, Xu A, Zhang B, Cai L, Hu Y, Sun C. Circulating plasma cells as a predictive biomarker in Multiple myeloma: an updated systematic review and meta-analysis. Ann Med 2024; 56:2338604. [PMID: 38599340 PMCID: PMC11008311 DOI: 10.1080/07853890.2024.2338604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/22/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Circulating plasma cells (CPCs) are defined by the presence of peripheral blood clonal plasma cells, which would contribute to the progression and dissemination of multiple myeloma (MM). An increasing number of studies have demonstrated the predictive potential of CPCs in the past few years. Therefore, there is a growing need for an updated meta-analysis to identify the specific relationship between CPCs and the prognosis of MM based on the current research status. METHODS The PubMed, Embase, and Cochrane Library databases were screened to determine eligible studies from inception to November 5, 2023. Publications that reported the prognostic value of CPCs in MM patients were included. Hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) and progression-free survival (PFS) were extracted to pool the results. Subgroup analyses were performed based on region, sample size, cut-off value, detection time, initial treatment, and data type. The association between CPCs level and clinicopathological characteristics, including the International Staging System (ISS), Revised-ISS (R-ISS), and cytogenetic abnormalities were also evaluated. Statistical analyses were conducted using STATA 17.0 software. RESULTS Twenty-two studies with a total of 5637 myeloma patients were enrolled in the current meta-analysis. The results indicated that myeloma patients with elevated CPCs were expected to have a poor OS (HR = 2.19, 95% CI: 1.81-2.66, p < 0.001) and PFS (HR = 2.45, 95% CI: 1.93-3.12, p < 0.001). Subgroup analyses did not alter the prognostic role of CPCs, regardless of region, sample size, cut-off value, detection time, initial treatment, or data type. Moreover, the increased CPCs were significantly related to advanced tumour stage (ISS III vs. ISS I-II: pooled OR = 2.89, 95% CI: 2.41-3.46, p < 0.001; R-ISS III vs. R-ISS I-II: pooled OR = 3.65, 95% CI: 2.43-5.50, p < 0.001) and high-risk cytogenetics (high-risk vs. standard-risk: OR = 2.22, 95% CI: 1.60-3.08, p < 0.001). CONCLUSION Our meta-analysis confirmed that the increased number of CPCs had a negative impact on the PFS and OS of MM patients. Therefore, CPCs could be a promising prognostic biomarker that helps with risk stratification and disease monitoring.
Collapse
Affiliation(s)
- Qun Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liping Zuo
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junying Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Zhao
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Aoshuang Xu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bo Zhang
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Cai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Sun
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
3
|
Zhang P, Xun L, Bao N, Tong D, Duan B, Peng D. Long-term mortality in patients with end-stage renal disease undergoing hemodialysis and peritoneal dialysis: a propensity score matching retrospective study. Ren Fail 2024; 46:2321320. [PMID: 38482569 PMCID: PMC10946263 DOI: 10.1080/0886022x.2024.2321320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Hemodialysis (HD) and peritoneal dialysis (PD) are effective ways to treat end-stage renal disease (ERSD). This study aimed to investigate the differences in survival and the factors that influence it in patients with end-stage renal disease treated with HD or PD. METHODS We retrospectively analyzed factors related to all-cause death with renal replacement therapy and compared the long-term mortality between HD and PD strategies in patients with ESRD who started HD or PD treatment in our renal HD center between January 1, 2008, and December 1, 2021. RESULTS Overall, 1,319 patients were included, comprising 690 and 629 patients in the HD and PD groups, respectively, according to the inclusion criteria. After propensity matching, 922 patients remained, with 461 (50%) patients each in the two groups. There were no significant differences in the 1-, 2-, 3-, and 4-year mortality rates between the HD and PD groups (all p > .05). However, the 5- and 10-year mortality rates of the matched patients were 15.8%. 17.6% in the HD group and 21.0%. 27.3% in the PD group, respectively. The 5- and 10-year mortality rates were significantly lower in the HD group (all p < .05) as compared to the PD group. After matching, Kaplan-Meier curve analysis with log-rank test was performed, which showed a significant difference in the survival rates between the two groups (p = .001). Logistic multifactor regression analysis revealed that age, weight, hypertension, serum creatinine, and combined neoplasms influenced the survival rate of patients with ESRD (p < .05). In contrast, age, hypertension, parathyroid hormone (PTH), serum creatinine, and peripheral vascular diseases (PVD) influenced the survival rate of patients in the HD group (p < .05), and age and weight influenced the survival rate of patients in the PD group (p < .05). CONCLUSIONS This study found that long-term mortality rates were higher in the PD group than that in the HD group, indicating that HD may be superior to PD.
Collapse
Affiliation(s)
- Pengjie Zhang
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| | - Liru Xun
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| | - Nan Bao
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| | - Ding Tong
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| | - Bin Duan
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| | - Du Peng
- Department of Nephrology, Shaanxi Provincial People’s hospital, Xian Jiaotong University, Xian, China
| |
Collapse
|
4
|
Lu C, Cheng S, Fan W, Zhang Z, Wang J. The relationship of platelet distribution width with all-cause and cardiovascular mortality in peritoneal dialysis patients. Ren Fail 2024; 46:2300730. [PMID: 38343320 PMCID: PMC10863511 DOI: 10.1080/0886022x.2023.2300730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major complication in peritoneal dialysis (PD) patients. Previous studies have demonstrated that platelet distribution width (PDW) is associated with cardiovascular events in hemodialysis (HD) patients. In this study, we hypothesized that elevated PDW can predict all-cause and cardiovascular mortality in PD patients. METHODS We recruited PD patients for a single-center retrospective cohort study from 1 January 2007, to 30 June 2020. Receiver-operating characteristic (ROC) curves were made to determine the PDW cutoff value for predicting all-cause mortality. The propensity score matching (PSM) method was used to improve the equilibrium between groups. The relation of PDW with all-cause and cardiovascular mortality was analyzed by Cox proportional hazards models. Restricted cubic spline (RCS) models were used to determine whether there was a linear relationship between PDW and all-cause and cardiovascular mortality. RESULTS A total of 720 PD patients were screened, and 426 PD patients were enrolled after PSM. After adjusting for confounders, Cox proportional hazards models showed that the PDW value was positively correlated with the risk of all-cause and cardiovascular mortality (HR = 1.162, 95% CI 1.057-1.278, p = 0.002 and HR = 1.200, 95% CI 1.041-1.382, p = 0.012). The adjusted RCS analysis further showed that the relationship of PDW with all-cause and cardiovascular mortality was linear (p for nonlinearly = 0.143 and 0.062). CONCLUSION Elevated PDW is independently associated with all-cause and cardiovascular mortality in PD patients.
Collapse
Affiliation(s)
- Chunyu Lu
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
| | - Shuiqin Cheng
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Wenjing Fan
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Zhihong Zhang
- National Clinical Research Center of Kidney Disease, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China
| | - Jinquan Wang
- Jinling Hospital Department of Nephrology, Nanjing Medical University, Nanjing, PR China
| |
Collapse
|
5
|
Zhang Y, Li L, Han Q, Wen L. The differential expression of AFF3 in cervical cancer and its correlation with clinicopathological features and prognosis. J OBSTET GYNAECOL 2024; 44:2333784. [PMID: 38602239 DOI: 10.1080/01443615.2024.2333784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/17/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Cervical cancer (CC) is the second most common malignancy in women, and identifying biomarkers of CC is crucial for prognosis prediction. Here, we investigated the expression of AF4/FMR2 Family Member 3 (AFF3) in CC and its association with clinicopathological features and prognosis. METHODS Tumour and adjacent tissues, along with clinicopathological features and follow-up information, were collected from 78 patients. AFF3 expression was assessed using quantitative real-time polymerase chain reaction and Western blotting. The correlation between AFF3 expression and CC symptoms was using chi-square test. The 5-year overall survival (OS) was analysed using the Kaplan-Meier method. The Univariate analysis of prognostic risk factors was conducted using the COX proportional hazards model, followed by multivariate COX regression analysis including variables with p < 0.01. RESULTS AFF3 expression was downregulated in CC, and its levels were correlated with lymph node metastasis (LNM) and International Federation of Gynaecology and Obstetrics (FIGO) stage. Patients with low AFF3 expression had a lower 5-year OS rate (52.78%, 19/36). Postoperative survival was reduced in patients with histological grade 3 (G3), myometrial invasion (depth ≥ 1/2), lymphovascular space invasion, LNM, and advanced FIGO stage. Low expression of AFF3 (HR: 2.848, 95% CI: 1.144-7.090) and histological grade G3 (HR: 4.393, 95% CI: 1.663-11.607) were identified as independent prognostic risk factors in CC patients. CONCLUSION Low expression of AFF3 and histological G3 are independent predictors of poor prognosis in CC patients, suggesting that AFF3 could serve as a potential biomarker for prognostic assessment in CC.
Collapse
Affiliation(s)
- Yaxuan Zhang
- Department of Gynaecology and Obstetrics, JiLin Provinc YanBian University Hospital (YanBian Hospital), Yanji City, China
| | - Lanying Li
- Department of Gynecology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou City, China
| | - Qingling Han
- Department of Gynaecology and Obstetrics, JiLin Provinc YanBian University Hospital (YanBian Hospital), Yanji City, China
| | - Lanying Wen
- Department of Gynaecology and Obstetrics, JiLin Provinc YanBian University Hospital (YanBian Hospital), Yanji City, China
| |
Collapse
|
6
|
Liu Q, Zheng K, Wang H, Song D, Li X. Changes in serum sodium concentration during hemodialysis is a predictor of mortality and cardio-cerebrovascular event. Ren Fail 2024; 46:2338483. [PMID: 38604948 PMCID: PMC11011235 DOI: 10.1080/0886022x.2024.2338483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/29/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Previous study consistently showed that lower serum sodium (SNa) was associated with a greater risk of mortality in hemodialysis (HD) patients. However, few studies have focused on the change in SNa (ΔSNa = post-HD SNa - pre-HD SNa) during an HD session. METHODS In a retrospective cohort of maintenance HD adults, all-cause mortality and cardio-cerebrovascular event (CCVE) were followed up for a medium of 82 months. Baseline pre-HD SNa and ΔSNa were collected; time-averaged pre-HD SNa and ΔSNa were computed as the mean values within 1-year, 2-year and 3-year intervals after enrollment. Cox proportional hazards models were used to evaluate the relationships of pre-HD and ΔSNa with outcomes. RESULTS Time-averaged pre-HD SNa were associated with all-cause mortality (2-year pre-HD SNa: HR [95% CI] 0.86 [0.74-0.99], p = 0.042) and CCVE (3-year pre-HD SNa: HR [95% CI] 0.83 [0.72-0.96], p = 0.012) with full adjustment. Time-averaged ΔSNa also demonstrated an association with all-cause mortality (3-year ΔSNa: HR [95% CI] 1.26 [1.03-1.55], p = 0.026) as well as with CCVE (3-year ΔSNa: HR [95% CI] 1.51 [1.21-1.88], p = <0.001) when fully adjusted. Baseline pre-HD SNa and ΔSNa didn't exhibit association with both outcomes. CONCLUSIONS Lower time-averaged pre-HD SNa and higher time-averaged ΔSNa were associated with a greater risk of all-cause mortality and CCVE in HD patients.
Collapse
Affiliation(s)
- Qixing Liu
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Ke Zheng
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haiyun Wang
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dan Song
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuemei Li
- Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
7
|
Zhang B, Li C, Wu J, Zhang J, Cheng C. DeepCG: A cell graph model for predicting prognosis in lung adenocarcinoma. Int J Cancer 2024; 154:2151-2161. [PMID: 38429627 PMCID: PMC11015971 DOI: 10.1002/ijc.34901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/31/2024] [Indexed: 03/03/2024]
Abstract
Lung cancer is the first leading cause of cancer-related death in the United States, with lung adenocarcinoma as the major subtype accounting for 40% of all cases. To improve patient survival, image-based prognostic models were developed due to the ready availability of pathological images at diagnosis. However, the application of these models is hampered by two main challenges: the lack of publicly available image datasets with high-quality survival information and the poor interpretability of conventional convolutional neural network models. Here, we integrated matched transcriptomic and H&E staining data from TCGA (The Cancer Genome Atlas) to develop an image-based prognostic model, termed Deep-learning based Cell Graph (DeepCG) model. Instead of survival data, we used a gene signature to predict patient prognostic risks, which was then used as labels for training DeepCG. Importantly, by employing graph structures to capture cell patterns, DeepCG can provide cell-level interpretation, which was more biologically relevant than previous region-level insights. We validated the prognostic values of DeepCG in independent datasets and demonstrated its ability to identify prognostically informative cells in images.
Collapse
Affiliation(s)
- Baoyi Zhang
- Department of Chemical and Biomolecular Engineering, Rice University, Houston, TX 77030
| | - Chenyang Li
- Genomic Medicine Department, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
- Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth Houston, Houston, TX 77030
| | - Jia Wu
- Department of Imaging Physics, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Jianjun Zhang
- Genomic Medicine Department, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
- Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth Houston, Houston, TX 77030
- Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Chao Cheng
- Department of Medicine, Baylor College of Medicine, Houston, TX 77030
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX 77030
- The Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX 77030
| |
Collapse
|
8
|
Yin X, Kishida R, Abe SK, Islam MR, Rahman MS, Saito E, Lan Q, Blechter B, Merritt M, Choi JY, Shin A, Katagiri R, Shu XO, Sawada N, Tamakoshi A, Koh WP, Tsuji I, Nagata C, Park SK, Kweon SS, Gao YT, Tsugane S, Kimura T, Yuan JM, Lu Y, Kanemura S, Sugawara Y, Wada K, Shin MH, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D, Seow WJ. Association between reproductive factors with lung cancer incidence and mortality: A pooled analysis of over 308,000 females in the Asia cohort consortium. Int J Cancer 2024; 154:2090-2105. [PMID: 38375919 DOI: 10.1002/ijc.34866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/06/2023] [Accepted: 12/29/2023] [Indexed: 02/21/2024]
Abstract
Previous studies have investigated the association between reproductive factors and lung cancer risk; however, findings have been inconsistent. In order to assess this association among Asian women, a total of 308,949 female participants from 11 prospective cohorts and four Asian countries (Japan, Korea, China, and Singapore) were included. Cox proportional hazards regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs). A total of 3,119 primary lung cancer cases and 2247 lung cancer deaths were identified with a mean follow-up of 16.4 years. Parous women had a lower risk of lung cancer incidence and mortality as compared with nulliparous women, with HRs of 0.82 (95% CI = 0.70-0.96) and 0.78 (95% CI = 0.65-0.94). The protective association of parity and lung cancer incidence was greater among ever-smokers (HR = 0.66, 95% CI = 0.49-0.87) than in never-smokers (HR = 0.90, 95% CI = 0.74-1.09) (P-interaction = 0.029). Compared with age at first delivery ≤20 years, older age at first delivery (21-25, ≥26 years) was associated with a lower risk of lung cancer incidence and mortality. Women who ever used hormone replacements had a higher likelihood of developing non-small cell lung cancer (HR = 1.31, 95% CI = 1.02-1.68), compared to those who never used hormone replacements. Future studies are needed to assess the underlying mechanisms, the relationships within these female reproductive factors, and the potential changes in smoking habits over time.
Collapse
Affiliation(s)
- Xin Yin
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Rie Kishida
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Sarah Krull Abe
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Md Rashedul Islam
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Hitotsubashi Institute for Advanced Study, Tokyo, Japan
| | - Md Shafiur Rahman
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Batel Blechter
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Melissa Merritt
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Aesun Shin
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ryoko Katagiri
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Sendai, Miyagi Prefecture, Japan
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yukai Lu
- Tohoku University Graduate School of Medicine, Sendai, Miyagi Prefecture, Japan
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Sendai, Miyagi Prefecture, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Sendai, Miyagi Prefecture, Japan
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Illinois, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Keitaro Matsuo
- Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - You-Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Manami Inoue
- Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Wei Jie Seow
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| |
Collapse
|
9
|
Nors J, Gotschalck KA, Erichsen R, Andersen CL. Incidence of late recurrence and second primary cancers 5-10 years after non-metastatic colorectal cancer. Int J Cancer 2024; 154:1890-1899. [PMID: 38323453 DOI: 10.1002/ijc.34871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/09/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
The fraction of patients who are cancer-free survivors 5 years after curative-intended surgery for colorectal cancer (CRC) is increasing, suggesting that extending surveillance beyond 5 years may be indicated. Here we estimate the incidence of late recurrence, metachronous CRC, and second primary cancers 5-10 years postoperative. All patients resected for UICC stage I-III CRC in Denmark through 2004-2013 were identified. Through individual-level linkage of nationwide health registry data, recurrence status was determined using a validated algorithm. Cancer-free survivors 5 years after surgery, were included. Cumulative incidence functions (CIF) of late recurrence, metachronous CRC, and second primary cancer 5-10 years postoperative were constructed. Subdistribution hazards ratios (sHR) were computed using Fine-Gray regression. Among 8883 patients, 370 developed late recurrence (5-10-year CIF = 4.1%, 95%CI: 3.7%-4.6%), 270 metachronous CRC (5-10-year CIF = 3.0%, 95%CI: 2.7%-3.4%), and 635 a second primary cancer (5-10-year CIF = 7.2%, 95%CI: 6.7%-7.7%). The risk of late recurrence was reduced for patients operated in 2009-2013 compared to 2004-2008 (2.9% vs. 5.6%, sHR = 0.52, 95% CI: 0.42-0.65). The risk of metachronous CRC was likewise reduced from 4.1% to 2.1% (sHR = 0.50, 95%CI: 0.39-0.65). While the risk of second primary cancer did not change between 2009-2013 and 2004-2008 (7.1% vs. 7.1%, sHR = 0.98, 95% CI: 0.84-1.15). Using nation-wide 10-year follow-up data, we document that the incidences of late recurrence and metachronous CRC are low and decreasing from 2004 to 2013. Thus, despite increasing numbers of long-term cancer survivors, the data do not advocate for extending CRC-specific surveillance beyond 5 years.
Collapse
Affiliation(s)
- Jesper Nors
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kåre Andersson Gotschalck
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Surgery, Horsens Regional Hospital, Horsens, Denmark
| | - Rune Erichsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Surgery, Randers Regional Hospital, Randers, Denmark
| | - Claus Lindbjerg Andersen
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
10
|
Yoo J, Hur J, Yoo J, Jurivich D, Lee KJ. A novel approach to quantifying individual's biological aging using Korea's national health screening program toward precision public health. GeroScience 2024; 46:3387-3403. [PMID: 38302843 PMCID: PMC11009216 DOI: 10.1007/s11357-024-01079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
Accurate prediction of biological age can inform public health measures to extend healthy lifespans and reduce chronic conditions. Multiple theoretical models and methods have been developed; however, their applicability and accuracy are still not extensive. Here, we report Differential Aging and Health Index (DAnHI), a novel measure of age deviation, developed using physical and serum biomarkers from four million individuals in Korea's National Health Screening Program. Participants were grouped into aging statuses (< 26 vs. ≥ 26, < 27 vs. ≥ 27, …, < 75 vs. ≥ 75 years) as response variables in a binary logistic regression model with thirteen biomarkers as independent variables. DAnHI for each individual was calculated as the weighted mean of their relative probabilities of being classified into each older age status, based on model ages ranging from 26 to 75. DAnHI in our large study population showed a steady increase with the increase in age and was positively associated with death after adjusting for chronological age. However, the effect size of DAnHI on the risk of death varied according to the age group and sex. The hazard ratio was highest in the 50-59-year age group and then decreased as the individuals aged. This study demonstrates that routine health check-up biomarkers can be integrated into a quantitative measure for predicting aging-related health status and death via appropriate statistical models and methodology. Our DAnHI-based results suggest that the same level of aging-related health status does not indicate the same degree of risk for death.
Collapse
Affiliation(s)
- Jinho Yoo
- YooJin BioSoft, 24, Jeongbalsan-Ro Ilsandong-Gu, Goyang-Si Gyeonggi-Do, 10402, Korea
| | - Junguk Hur
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Jintae Yoo
- YooJin BioSoft, 24, Jeongbalsan-Ro Ilsandong-Gu, Goyang-Si Gyeonggi-Do, 10402, Korea
| | - Donald Jurivich
- Department of Geriatrics, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, 58202, USA
| | - Kyung Ju Lee
- Department of Women's Rehabilitation, National Rehabilitation Center, 58, Samgaksan-Ro, Gangbuk-Gu, Seoul, 01022, Korea.
- Institute for Occupational & Environmental Health, Korea University, Seoul, 02841, Korea.
| |
Collapse
|
11
|
Ishida S, Kitaji Y, Yasuda K, Yamashita H, Harashima H, Miyano S. Association of comorbidities with postoperative walking independence in patients with hip fractures: a single-center, retrospective, observational study. Int J Rehabil Res 2024; 47:110-115. [PMID: 38517124 DOI: 10.1097/mrr.0000000000000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Hip fractures (HFs) are common in the elderly and lead to decreased walking independence. Although comorbidities may be associated with gaining walking independence, few studies have comprehensively examined baseline and preoperative clinical factors. We aimed to evaluate the effects of comorbidities on the postoperative walking independence of patients with HFs. This single-center, retrospective, observational study included patients with HFs admitted to an acute care hospital between 1 May 2022 and 1 March 2023, who before the incident were able to walk independently [functional independence measure (FIM) walk score ≥6 points]. Postoperative walking independence was evaluated using the walk item of the FIM. The Charlson comorbidity index (CCI) was used to evaluate comorbidities at admission, and the patients were divided into two categories with CCI scores of 0 points and ≥1 point. The effect of comorbidities, assessed using the CCI, on postoperative walking independence was evaluated using Cox proportional hazards analysis. Ninety-four participants were included in the analysis. The Cox proportional hazards model adjusted for potential confounders (age, operative delay and nutritional status) revealed that the CCI was significantly associated with postoperative walking independence ( P < 0.05). The hazard ratio and 95% confidence interval (CI) for the CCI for postoperative walking independence were 0.40 (95% CI, 0.189-0.865). Preoperative assessment of comorbidities using the CCI may aid in predicting the postoperative walking independence of patients with HFs.
Collapse
Affiliation(s)
- Shinnosuke Ishida
- Department of Rehabilitation, Tokyo General Hospital, Nakano-ku, Japan
| | | | | | | | | | | |
Collapse
|
12
|
Wang Y, Wu W, Bravo MA, Liu S, Xi X, Zhou Y, Zhang Q, Liu Q. Prepubertal exposure to polycyclic aromatic hydrocarbons are associated with early pubertal development onset in boys: A longitudinal study. J Hazard Mater 2024; 470:134160. [PMID: 38574665 DOI: 10.1016/j.jhazmat.2024.134160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/23/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE To investigate the effects of polycyclic aromatic hydrocarbons(PAHs) on puberty in boys. METHODS 695 subjects were selected from four primary schools in Chongqing, China. 675 urine samples from these boys were collected four PAH metabolites: 1-hydroxypyrene, 2-hydroxynaphthoic, 2-hydroxyfluorene, and 9-hydroxyphenanthrene. Pubertal development of 695 boys was assessed at follow-up visits starting in December 2015 and occurring every six months thereafter until now, data used in this article ending in June 2021. A total of 12 follow-up visits were performed. Cox proportional hazards regression models were used to analyze the relationship between PAH metabolite concentrations and indicators of pubertal timing. RESULTS The mean age at puberty onset of testicular volume, facial hair, pubic hair, first ejaculation, and axillary hair in boys was 11.66, 12.43, 12.51, 12.72 and 13.70 years, respectively. Cox proportional hazards regression models showed that boys with moderate level of 1-OHPyr exposure was associated with earlier testicular development (hazard ratio [HR] = 1.276, 95% confidence interval [CI]: 1.006-1.619), with moderate level of 2-OHNap were at higher risk of early testicular development (HR = 1.273, 95% CI: 1.002-1.617) and early axillary hair development (HR = 1.355, 95% CI: 1.040-1.764), with moderate level of 2-OHFlu was associated with earlier pubic hair development (HR = 1.256, 95% CI: 1.001-1.577), with high level of 9-OHPhe were at higher risk of early fisrt ejaculation (HR = 1.333, 95% CI: 1.005-1.767) and early facial hair development (HR = 1.393, 95% CI: 1.059-1.831). CONCLUSION Prepubertal exposure to PAHs may be associated with earlier pubertal development in boys.
Collapse
Affiliation(s)
- Yujie Wang
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Wenyi Wu
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Mercedes A Bravo
- Duke Global Health Institute, Duke University, Durham, NC, United States
| | - Shudan Liu
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Xuan Xi
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Yuanke Zhou
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Qin Zhang
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China
| | - Qin Liu
- Research Center for Environment and Human Health, Research Center for Medicine and Social Development, School of Public Health, Chongqing Medical University, Chongqing 401331, PR China.
| |
Collapse
|
13
|
Aoki S, Yamagishi K, Maruyama K, Ikeda A, Nagao M, Noda H, Umesawa M, Hayama-Terada M, Muraki I, Okada C, Tanaka M, Kishida R, Kihara T, Takada M, Shimizu Y, Ohira T, Imano H, Sankai T, Okada T, Tanigawa T, Kitamura A, Kiyama M, Iso H. Mushroom intake and risk of incident disabling dementia: the Circulatory Risk in Communities Study (CIRCS). Br J Nutr 2024; 131:1641-1647. [PMID: 38239014 DOI: 10.1017/s000711452400014x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Abstract
It is uncertain whether dietary intake of mushrooms rich in dietary fibre and several antioxidants is associated with a lower risk of dementia. We sought to examine prospectively the association between mushroom intake and the risk of disabling dementia. We performed a prospective study involving 3750 people aged 40 to 64 years residing in three communities who participated in an annual cardiovascular risk survey from 1985 to 1999. Cases of incident disabling dementia were surveyed from 1999 to 2020. We calculated the hazard ratios (HR) and 95 % CI for incident total dementia according to mushroom intake among participants with or without a history of stroke. During a mean 16·0 years' follow-up in 3739 eligible participants, 670 people developed disabling dementia. For women, mushroom intake was inversely associated with the risk of total dementia and the association was confined to dementia without a history of stroke. The multivariable HR (95 % CI) for total dementia in women were 0·81 (0·62, 1·06) for mushroom intake of 0·1-14·9 g/d and 0·56 (0·42, 0·75) for mushroom intake above 15·0 g/d (Pfor trend = 0·003) compared with no intake. The corresponding HR (95 % CI) for dementia without a history of stroke were 0·66 (0·47, 0·93) and 0·55 (0·38, 0·79) (Pfor trend = 0·01). In men, no associations were observed between mushroom intake and the risk of disabling dementia. Among Japanese women, dietary mushroom intake was associated with a lower risk of disabling dementia.
Collapse
Affiliation(s)
- Shoko Aoki
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Doctoral Program in Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Kotatsu Maruyama
- Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan
| | - Ai Ikeda
- Department of Public Health, Juntendo University, Tokyo, Japan
| | - Masanori Nagao
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hiroyuki Noda
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Dokkyo Medical University, School of Medicine, Mibu, Japan
| | | | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chika Okada
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Mari Tanaka
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Rie Kishida
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Tomomi Kihara
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Midori Takada
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Yuji Shimizu
- Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hironori Imano
- Department of Public Health, Kindai University, Osakasayama, Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | | | | | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention, Osaka, Japan
| | - Hiroyasu Iso
- Department of Public Health Medicine, Institute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Munko M, Ditzhaus M, Dobler D, Genuneit J. RMST-based multiple contrast tests in general factorial designs. Stat Med 2024; 43:1849-1866. [PMID: 38402907 DOI: 10.1002/sim.10017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/13/2023] [Accepted: 01/06/2024] [Indexed: 02/27/2024]
Abstract
Several methods in survival analysis are based on the proportional hazards assumption. However, this assumption is very restrictive and often not justifiable in practice. Therefore, effect estimands that do not rely on the proportional hazards assumption are highly desirable in practical applications. One popular example for this is the restricted mean survival time (RMST). It is defined as the area under the survival curve up to a prespecified time point and, thus, summarizes the survival curve into a meaningful estimand. For two-sample comparisons based on the RMST, previous research found the inflation of the type I error of the asymptotic test for small samples and, therefore, a two-sample permutation test has already been developed. The first goal of the present paper is to further extend the permutation test for general factorial designs and general contrast hypotheses by considering a Wald-type test statistic and its asymptotic behavior. Additionally, a groupwise bootstrap approach is considered. Moreover, when a global test detects a significant difference by comparing the RMSTs of more than two groups, it is of interest which specific RMST differences cause the result. However, global tests do not provide this information. Therefore, multiple tests for the RMST are developed in a second step to infer several null hypotheses simultaneously. Hereby, the asymptotically exact dependence structure between the local test statistics is incorporated to gain more power. Finally, the small sample performance of the proposed global and multiple testing procedures is analyzed in simulations and illustrated in a real data example.
Collapse
Affiliation(s)
- Merle Munko
- Department of Mathematics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Marc Ditzhaus
- Department of Mathematics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Dennis Dobler
- Department of Mathematics, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jon Genuneit
- Department of Pediatrics, Leipzig University, Leipzig, Germany
| |
Collapse
|
15
|
Young S, Sanghvi T, Ragulojan R, Torkian P, Todatry S, D'Souza D, Flanagan S, Golzarian J. Local recurrence following a complete radiologic response in hepatocellular carcinoma patients: comparison of transarterial chemoembolisation and transarterial radioembolisation. Clin Radiol 2024; 79:371-377. [PMID: 38341344 DOI: 10.1016/j.crad.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/11/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
AIM To evaluate and compare the rates of local recurrence in hepatocellular carcinoma (HCC) patients who undergo selective transarterial radioembolisation (TARE) or transarterial chemoembolisation (TACE) and achieve a complete response (CR) radiologically. MATERIALS AND METHODS All patients undergoing treatment with TARE or TACE at a single academic institution were reviewed retrospectively. Those who had been treated previously, presented with multifocal disease, had non-selective TARE or TACE, or did not achieve a complete response (CR) radiologically were excluded. RESULTS In total 110 patients were included (TACE n=60 [54.5%]; TARE n=50 [45.5%]). TARE patients were older (66.4 ± 9.4 versus 61.2 ± 5.6 years, p<0.001) and had larger tumours (4.4 ± 2.2 versus 3 ± 1.4 cm, p=0.002). TACE patients were significantly more likely to suffer a local recurrence (31/60, 51.7% versus 9/50, 18%, p<0.001) and had a significantly shorter time to recurrence (median 8.3 {interquartile range [IQR]}: 12 versus median 17.9 [IQR: 23.5] months, p=0.001). A local time to progression (TTP) Kaplan-Meier curve demonstrated TACE patients had a significantly shorter local TTP (hazard ratio [HR]: 7.2; 95% confidence interval [CI]: 3.64-14.24; p<0.001) and treatment modality (TACE or TARE; HR: 0.05; 95% CI: 0.005-0.5; p=0.01) was found to be associated with local recurrences on multivariate Cox proportional HR analysis. When overall TTP was evaluated, again TACE patients were found to have a significantly shorter TTP (HR: 2.13 [1.28-3.53], p=0.004). CONCLUSION In HCC patients undergoing selective treatment who achieve a CR radiologically, those treated with TARE may be less likely to suffer recurrence, either local or general, than those treated with TACE.
Collapse
Affiliation(s)
- S Young
- Department of Radiology, University of Arizona, Division of Interventional Radiology, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724, USA.
| | - T Sanghvi
- Minneapolis VA Hospital, 1 Veterans Dr, Minneapolis, MN 55417, USA
| | - R Ragulojan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - P Torkian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Todatry
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - D D'Souza
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Flanagan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - J Golzarian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| |
Collapse
|
16
|
Yang H, Wang Z, Zhou Y, Gao Z, Xu J, Xiao S, Dai C, Wu F, Deng Z, Peng J, Ran P. Association between long-term ozone exposure and readmission for chronic obstructive pulmonary disease exacerbation. Environ Pollut 2024; 348:123811. [PMID: 38531467 DOI: 10.1016/j.envpol.2024.123811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024]
Abstract
The relationship between long-term ozone (O₃) exposure and readmission for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains elusive. In this study, we collected individual-level information on AECOPD hospitalizations from a standardized electronic database in Guangzhou from January 1, 2014, to December 31, 2015. We calculated the annual mean O₃ concentration prior to the dates of the index hospitalization for AECOPD using patients' residential addresses. Employing Cox proportional hazards models, we assessed the association between long-term O₃ concentration and the risk of AECOPD readmission across several time frames (30 days, 90 days, 180 days, and 365 days). We estimated the disease and economic burden of AECOPD readmissions attributable to O₃ using a counterfactual approach. Of the 4574 patients included in the study, 1398 (30.6%) were readmitted during the study period, with 262 (5.7%) readmitted within 30 days. The annual mean O₃ concentration was 90.3 μg/m3 (standard deviation [SD] = 8.2 μg/m3). A 10-μg/m3 increase in long-term O₃ concentration resulted in a hazard ratio (HR) for AECOPD readmission within 30 days of 1.28 (95% confidence interval [CI], 1.09 to 1.49), with similar results for readmission within 90, 180, and 365 days. Older patients (aged 75 years or above) and males were more susceptible (HR, 1.33; 95% CI, 1.10-1.61 and HR, 1.29; 95% CI, 1.09-1.53, respectively). The population attributable fraction for 30-day readmission due to O₃ exposure was 29.0% (95% CI, 28.4%-30.0%), and the attributable mean cost per participant was 362.3 USD (354.5-370.2). Long-term exposure to elevated O₃ concentrations is associated with an increased risk of AECOPD readmission, contributing to a significant disease and economic burden.
Collapse
Affiliation(s)
- Huajing Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Guangzhou National Laboratory, Guangzhou, Guangdong, Postcode, China
| | - Zihui Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Guangzhou National Laboratory, Guangzhou, Guangdong, Postcode, China
| | - Zhaosheng Gao
- Guangzhou Health Technology Appraisal and Talent Evaluation Center, Guangzhou Municipal Health Commission, Guangzhou, China
| | - Jing Xu
- Guangzhou Health Technology Appraisal and Talent Evaluation Center, Guangzhou Municipal Health Commission, Guangzhou, China
| | - Shan Xiao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Department of Pulmonary and Critical Care Medicine, Shenzhen Longgang District Central Hospital, Shenzhen, China
| | - Cuiqiong Dai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China
| | - Fan Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Guangzhou National Laboratory, Guangzhou, Guangdong, Postcode, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China
| | - Jieqi Peng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Guangzhou National Laboratory, Guangzhou, Guangdong, Postcode, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, Postcode, China; Guangzhou National Laboratory, Guangzhou, Guangdong, Postcode, China.
| |
Collapse
|
17
|
Wu CY, Yeh CM, Tsai CK, Liu CJ. The influence of hospital volume and physician volume on early mortality in acute promyelocytic leukemia patients. Ann Hematol 2024; 103:1577-1586. [PMID: 38532122 PMCID: PMC11009737 DOI: 10.1007/s00277-024-05616-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/02/2024] [Indexed: 03/28/2024]
Abstract
Acute promyelocytic leukemia (APL) is a highly curable hematologic malignancy in the era of all-trans retinoic acid (ATRA) combination treatment. However, only a modest change in early mortality rate has been observed despite the wide availability of ATRA. In addition to the clinical characteristics of APL patients, studies on the hospital volume-outcome relationship and the physician volume-outcome relationship remained limited. We aim to evaluate the association between hospital and physician volume and the early mortality rate among APL patients. The patients were collected from Taiwan's National Health Insurance Research Database (NHIRD). Early mortality is defined as death within 30 days of diagnosis. Patients were categorized into four groups according to individual cumulative hospital and physician volume. The risk of all-cause mortality in APL patients with different cumulative volume groups was compared using a Cox proportional hazard model. The probability of overall survival was estimated using the Kaplan-Meier method. All 741 patients were divided into four quartile volume groups. In the multivariate analysis, only physician volume was significantly associated with early mortality rate. The physician volume of the highest quartile was a protective factor for early mortality compared with the physician volume of the lowest quartile (HR 0.10, 95% CI 0.02-0.65). Hospital characteristics were not associated with early mortality. In the sensitivity analyses, the results remained consistent using two other different definitions of early mortality. Higher physician volume was independently associated with lower early mortality, while hospital volume was not. Enhancing the clinical expertise of low-volume physicians may ensure better outcomes.
Collapse
Affiliation(s)
- Chia-Ying Wu
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chiu-Mei Yeh
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Kuang Tsai
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Division of Hematology, Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Chia-Jen Liu
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
- Division of Hematology, Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, Taipei, Taiwan.
| |
Collapse
|
18
|
Untch M, Pérol D, Mayer EL, Cortes J, Nusch A, Cameron D, Barrios C, Delea T, Danyliv A, Mishra N, Gupta R, Pathak P, Fasching PA. Disease-free survival as a surrogate for overall survival in HR+/HER2- early breast cancer: A correlation analysis. Eur J Cancer 2024; 202:113977. [PMID: 38460476 DOI: 10.1016/j.ejca.2024.113977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Overall survival (OS) is a universally accepted measure of clinical benefit; however, prolonged follow-up is needed to observe sufficient events. Disease-free survival (DFS) has been widely adopted as a primary endpoint for early breast cancer (EBC) trials, as follow-up is comparatively shorter. Here, we present an analysis evaluating DFS as a surrogate for OS for adjuvant treatment of hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) EBC. METHODS A systematic literature review which included randomized controlled trials (RCTs) with ≥80% of adult patients with HR+/HER2- EBC was conducted. The RCTs evaluated various systemic therapeutic categories; key inclusion criteria included reporting of DFS and OS hazard ratios (HRs) and mature OS data. Spearman rank correlation and weighted linear regression analyses evaluated DFS and OS HR correlation. A scenario analysis tested base-case analysis robustness, and a parallel analysis using patient-level data was conducted. RESULTS The base case (N = 14 RCTs) showed an unweighted Spearman coefficient of 0.81 between OS and DFS (weighted: 0.81), with 84% of the variability in OS explained by DFS differences (R2 from weighted regression). The surrogate threshold effect (Burzykowski T, Buyse M. Pharm Stat. 2006;5:173-186) was 0.82 for DFS/OS HR. Scenario analysis (n = 9 RCTs), which excluded chemotherapy trials, and patient-level analysis using FACE trial data were consistent with the base-case analysis. CONCLUSIONS These analyses support DFS as a reliable surrogate endpoint for OS in adjuvant HR+/HER2- EBC trials. Using DFS as a surrogate measure will permit timelier access to novel treatments for patients with HR+/HER2- EBC.
Collapse
Affiliation(s)
- Michael Untch
- Interdisciplinary Breast Cancer Center, Helios Klinikum Berlin-Buch, Berlin, Germany.
| | | | - Erica L Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Javier Cortes
- International Breast Cancer Center (IBCC), Grupo Quiron, Madrid & Barcelona, Spain
| | - Arnd Nusch
- Practice for Hematology and Internal Oncology, Velbert, Germany
| | - David Cameron
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK
| | - Carlos Barrios
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
| | | | | | | | - Rhea Gupta
- Novartis Healthcare Pvt Ltd, Hyderabad, India
| | - Purnima Pathak
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - Peter A Fasching
- University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| |
Collapse
|
19
|
von Koskull A, Hagström J, Haglund C, Kaprio T, Böckelman C. High-tissue FRMD6 expression predicts better outcomes among colorectal cancer patients. Biomarkers 2024; 29:127-133. [PMID: 38385211 DOI: 10.1080/1354750x.2024.2321916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Colorectal cancer (CRC) is the second most common cause of cancer-related deaths. The hippo pathway works as a regulator of organ growth and is often a target for mutations in cancer. Ferm domain containing protein 6 (FRMD6) is an activator of the hippo pathway. This study aimed to explore the role of FRMD6 in CRC and to determine how well it works as a prognostic factor among CRC patients. METHODS The tumor expression of FRMD6 was evaluated using immunohistochemistry in 538 colorectal patients operated on at Helsinki University Hospital. We assessed FRMD6 expression with clinicopathological parameters and the impact of FRMD6 expression on survival. RESULTS Patients with a high FRMD6 expression exhibited a better prognosis (univariable hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.41-0.81), with a 5-year disease-specific survival (DSS) of 66.3%. By contrast, patients with a low FRMD6 expression had a 5-year DSS of 52.8%. A high FRMD6 expression level served as an independent predictor for better survival in the Cox multivariable survival analysis (HR 0.53, 95% CI 0.33-0.86). DISCUSSION To our knowledge, this is the first study to show that a high FRMD6 expression is an independent marker for a better prognosis in CRC and could help determine the prognosis for CRC patients.
Collapse
Affiliation(s)
- Arthur von Koskull
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaana Hagström
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Oral Pathology and Radiology, University of Turku, Turku, Finland
| | - Caj Haglund
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuomas Kaprio
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Camilla Böckelman
- Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| |
Collapse
|
20
|
Shimohata H, Usui J, Tawara-Iida T, Ebihara I, Ishizu T, Maeda Y, Kobayashi H, Numajiri D, Kaneshige A, Sega M, Yamashita M, Ohgi K, Maruyama H, Takayasu M, Hirayama K, Kobayashi M, Yamagata K. NT-pro BNP level at dialysis initiation is a useful biomarker for predicting hospitalization for ischemic heart disease. Clin Exp Nephrol 2024; 28:457-464. [PMID: 38238500 DOI: 10.1007/s10157-023-02442-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/28/2023] [Indexed: 04/23/2024]
Abstract
BACKGROUND Patients with end-stage kidney disease (ESKD) are at high risk of cardiovascular disease including stroke, heart failure, and ischemic heart disease (IHD). To prevent the occurrence and progression of CVD, a reliable prognostic cardiac biomarker is essential. We investigated the prognostic value of NT-proBNP for each incident type of CVD. METHODS Male patients from the Ibaraki Dialysis Initiation Cohort (iDIC) study with preserved serum samples from dialysis initiation day (n = 212) were analyzed. Patients were classified into four groups according to quartiles of baseline NT-pro BNP levels. The relationship between NT-proBNP levels at the initiation of dialysis and the subsequent incidence of hospitalization events due to IHD, heart failure, and stroke was analyzed. RESULTS The incidence rate for hospitalization due to IHD was significantly higher in the highest NT-proBNP category (Log rank p = 0.008); those of stroke and heart failure showed no significant differences among quartiles. Cox proportional hazards regression analysis revealed that serum NT-proBNT was the only prognostic factor for hospitalization for IHD after adjustment by major known IHD risk factors. (HR, 1.008; 95% confidence interval, 1.002-1.014; p = 0.01) The ROC curve analysis for the incidence of hospitalization due to IHD showed that NT-proBNP had an area under the curve (AUC) of 0.759 (95% CI 0.622-0.897; p = 0.004) at a cut-off value of 956.6 pg/mL. CONCLUSION NT-proBNP measurement at the initiation of dialysis therapy is useful to predict later hospitalization for IHD. TRIAL REGISTRATION UMIN000010806.
Collapse
Affiliation(s)
- Homare Shimohata
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
| | - Joichi Usui
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Tsukuba, Japan
| | | | - Itaru Ebihara
- Department of Nephrology, Mito Saiseikai General Hospital, Ibaraki, Mito, Japan
| | - Takashi Ishizu
- Department of Nephrology, Ushiku Aiwa General Hospital, Ibaraki, Ushiku, Japan
| | - Yoshitaka Maeda
- Nephrology Division, Department of Internal Medicine, JA Toride Medical Center, Ibaraki, Toride, Japan
| | - Hiroaki Kobayashi
- Department of Nephrology, Ibaraki Prefectural Center Hospital, Ibaraki, Kasama, Japan
| | - Daichi Numajiri
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Ayaka Kaneshige
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Masatoshi Sega
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Marina Yamashita
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Kentaro Ohgi
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Hiroshi Maruyama
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Mamiko Takayasu
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | - Kouichi Hirayama
- Department of Nephrology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan
| | | | - Kunihiro Yamagata
- Department of Nephrology, Faculty of Medicine, University of Tsukuba, Ibaraki, Tsukuba, Japan
| |
Collapse
|
21
|
Hawwash NK, Sperrin M, Martin GP, Joshu CE, Florido R, Platz EA, Renehan AG. Overweight-years and cancer risk: A prospective study of the association and comparison of predictive performance with body mass index (Atherosclerosis Risk in Communities Study). Int J Cancer 2024; 154:1556-1568. [PMID: 38143298 PMCID: PMC7615716 DOI: 10.1002/ijc.34821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023]
Abstract
Excess body mass index (BMI) is associated with a higher risk of at least 13 cancers, but it is usually measured at a single time point. We tested whether the overweight-years metric, which incorporates exposure time to BMI ≥25 kg/m2 , is associated with cancer risk and compared this with a single BMI measure. We used adulthood BMI readings in the Atherosclerosis Risk in Communities (ARIC) study to derive the overweight-years metric. We calculated associations between the metric and BMI and the risk of cancers using Cox proportional hazards models. Models that either included the metric or BMI were compared using Harrell's C-statistic. We included 13,463 participants, with 3,876 first primary cancers over a mean of 19 years (SD 7) of cancer follow-up. Hazard ratios for obesity-related cancers per standard deviation overweight-years were 1.15 (95% CI: 1.05-1.25) in men and 1.14 (95% CI: 1.08-1.20) in women. The difference in the C-statistic between models that incorporated BMI, or the overweight-years metric was non-significant in men and women. Overweight-years was associated with the risk of obesity-related cancers but did not outperform a single BMI measure in association performance characteristics.
Collapse
Affiliation(s)
- Nadin K. Hawwash
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Cancer Research UK, Manchester Cancer Research Centre, Manchester, UK
| | - Matthew Sperrin
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Glen P. Martin
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Corinne E. Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Roberta Florido
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland, USA
| | - Andrew G. Renehan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Manchester, UK
| |
Collapse
|
22
|
Horn A, Adgent MA, Osmundson SS, Wiese AD, Phillips SE, Patrick SW, Griffin MR, Grijalva CG. Risk of Death at 1 Year Following Postpartum Opioid Exposure. Am J Perinatol 2024; 41:949-960. [PMID: 35640619 PMCID: PMC9708936 DOI: 10.1055/s-0042-1745848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Opioids are commonly prescribed to women for acute pain following childbirth. Postpartum prescription opioid exposure is associated with adverse opioid-related morbidities but the association with all-cause mortality is not well studied. This study aimed to examine the association between postpartum opioid prescription fills and the 1-year risk of all-cause mortality among women with live births. METHODS In a retrospective cohort study of live births among women enrolled in Tennessee Medicaid (TennCare) between 2007 and 2015, we compared women who filled two or more postpartum outpatient opioid prescriptions (up to 41 days of postdelivery discharge) to women who filled one or fewer opioid prescription. Women were followed from day 42 postdelivery discharge through 365 days of follow-up or date of death. Deaths were identified using linked death certificates (2007-2016). We used Cox's proportional hazard regression and inverse probability of treatment weights to compare time to death between exposure groups while adjusting for relevant confounders. We also examined effect modification by delivery route, race, opioid use disorder, use of benzodiazepines, and mental health condition diagnosis. RESULTS Among 264,135 eligible births, 216,762 (82.1%) had one or fewer maternal postpartum opioid fills and 47,373 (17.9%) had two or more fills. There were 182 deaths during follow-up. The mortality rate was higher in women with two or more fills (120.5 per 100,000 person-years) than in those with one or fewer (57.7 per 100,000 person-years). The risk of maternal death remained higher in participants exposed to two or more opioid fills after accounting for relevant covariates using inverse probability of treatment weighting (adjusted hazard ratio: 1.46 [95% confidence interval: 1.01, 2.09]). Findings from stratified analyses were consistent with main findings. CONCLUSION Filling two or more opioid prescriptions during the postpartum period was associated with a significant increase in 1-year risk of death among new mothers. KEY POINTS · Opioid prescribing in the postpartum period is common.. · Prior studies show that >1 postnatal opioid fill is associated with adverse opioid-related events.. · > 1 opioid fill within 42 days of delivery was associated with an increase in 1-year risk of death..
Collapse
Affiliation(s)
- Arlyn Horn
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Margaret A. Adgent
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Sarah S. Osmundson
- Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN
| | - Andrew D. Wiese
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Sharon E. Phillips
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Stephen W. Patrick
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Marie R. Griffin
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Veterans’ Health Administration Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Nashville, TN
| | - Carlos G. Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
- Veterans’ Health Administration Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center (GRECC), Nashville, TN
| |
Collapse
|
23
|
Pham TT, Nimptsch K, Aleksandrova K, Jenab M, Fedirko V, Wu K, Eriksen AK, Tjønneland A, Severi G, Rothwell J, Kaaks R, Katzke V, Catalano A, Agnoli C, Masala G, De Magistris MS, Tumino R, Vermeulen R, Aizpurua A, Trobajo-Sanmartín C, Chirlaque MD, Sánchez MJ, Lu SSM, Cross AJ, Christakoudi S, Weiderpass E, Pischon T. Pre-diagnostic circulating resistin concentrations and mortality among individuals with colorectal cancer: Results from the European Prospective Investigation into Cancer and Nutrition study. Int J Cancer 2024; 154:1596-1606. [PMID: 38200695 DOI: 10.1002/ijc.34830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/13/2023] [Accepted: 12/01/2023] [Indexed: 01/12/2024]
Abstract
Resistin is a protein involved in inflammation and angiogenesis processes and may play a role in the progression of colorectal cancer (CRC). However, it remains unclear whether resistin is associated with increased mortality after CRC diagnosis. We examined pre-diagnostic serum resistin concentrations in relation to CRC-specific and all-cause mortality among 1343 incident CRC cases from the European Prospective Investigation into Cancer and Nutrition cohort. For CRC-specific mortality as the primary outcome, hazard ratios (HRs) and 95% confidence intervals (95% CI) were estimated from competing risk analyses based on cause-specific Cox proportional hazards models and further in sensitivity analyses using Fine-Gray proportional subdistribution hazards models. For all-cause mortality as the secondary outcome, Cox proportional hazards models were used. Subgroup analyses were performed by sex, tumor subsite, tumor stage, body mass index and time to CRC diagnosis. Resistin was measured on a median of 4.8 years before CRC diagnosis. During a median follow-up of 8.2 years, 474 deaths from CRC and 147 deaths from other causes were observed. Resistin concentrations were not associated with CRC-specific mortality (HRQ4vsQ1 = 0.95, 95% CI: 0.73-1.23; Ptrend = .97; and HRper doubling of resistin concentration = 1.00; 95% CI: 0.84-1.19; P = .98) or all-cause mortality. Results from competing risk (sensitivity) analysis were similar. No associations were found in any subgroup analyses. These findings suggest no association between pre-diagnostic circulating resistin concentrations and CRC-specific or all-cause mortality among persons with CRC, and the potential insignificance of resistin in CRC progression.
Collapse
Affiliation(s)
- Thu Thi Pham
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Hum-boldt-Universität zu Berlin, Berlin, Germany
| | - Katharina Nimptsch
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Krasimira Aleksandrova
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Mazda Jenab
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), World Health Organization, Lyon, France
| | - Veronika Fedirko
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | | | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Inserm "Exposome and Heredity" Team, Villejuif, France
| | - Joseph Rothwell
- Université Paris-Saclay, UVSQ, Inserm "Exposome and Heredity" Team, Villejuif, France
| | - Rudolf Kaaks
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Alberto Catalano
- Centre for Biostatistics, Epidemiology, and Public Health, Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Rosario Tumino
- Hyblean Association for Epidemiological Research, AIRE ONLUS, Ragusa, Italy
| | - Roel Vermeulen
- Institute of Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Amaia Aizpurua
- Ministry of Health of the Basque Government, Sub Directorate for Public Health and Addictions of Gipuzkoa, San Sebastian, Spain
- Biodonostia Health Research Institute, Epidemiology of Chronic and Communicable Diseases Group, San Sebastián, Spain
| | - Camino Trobajo-Sanmartín
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Navarre Institute for Health Research (IdiSNA), Pamplona, Spain
| | - María-Dolores Chirlaque
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia University, Murcia, Spain
| | - Maria-Jose Sánchez
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Sai San Moon Lu
- Department of Radiation Sciences, Oncology Unit, Umeå University, Umeå, Sweden
| | - Amanda J Cross
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Inflammation Biology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Hum-boldt-Universität zu Berlin, Berlin, Germany
- Biobank Technology Platform, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- Core Facility Biobank, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
24
|
Janczewski LM, Browner A, Cotler J, Nelson H, Ballman KV, LeBlanc M, Gollub MJ, Eng C, Brierley JD, Palefsky JM, Goldberg RM, Goodman KA, Washington MK, Asare EA, Palis B. Data-driven optimization of version 9 American Joint Committee on Cancer staging system for anal cancer. Cancer 2024; 130:1702-1710. [PMID: 38140735 DOI: 10.1002/cncr.35155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/25/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION The American Joint Committee on Cancer (AJCC) staging system undergoes periodic revisions to maintain contemporary survival outcomes related to stage. Recently, the AJCC has developed a novel, systematic approach incorporating survival data to refine stage groupings. The objective of this study was to demonstrate data-driven optimization of the version 9 AJCC staging system for anal cancer assessed through a defined validation approach. METHODS The National Cancer Database was queried for patients diagnosed with anal cancer in 2012 through 2017. Kaplan-Meier methods analyzed 5-year survival by individual clinical T category, N category, M category, and overall stage. Cox proportional hazards models validated overall survival of the revised TNM stage groupings. RESULTS Overall, 24,328 cases of anal cancer were included. Evaluation of the 8th edition AJCC stage groups demonstrated a lack of hierarchical prognostic order. Survival at 5 years for stage I was 84.4%, 77.4% for stage IIA, and 63.7% for stage IIB; however, stage IIIA disease demonstrated a 73.0% survival, followed by 58.4% for stage IIIB, 59.9% for stage IIIC, and 22.5% for stage IV (p <.001). Thus, stage IIB was redefined as T1-2N1M0, whereas Stage IIIA was redefined as T3N0-1M0. Reevaluation of 5-year survival based on data-informed stage groupings now demonstrates hierarchical prognostic order and validated via Cox proportional hazards models. CONCLUSION The 8th edition AJCC survival data demonstrated a lack of hierarchical prognostic order and informed revised stage groupings in the version 9 AJCC staging system for anal cancer. Thus, a validated data-driven optimization approach can be implemented for staging revisions across all disease sites moving forward.
Collapse
Affiliation(s)
- Lauren M Janczewski
- Department of Surgery, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA
- American College of Surgeons Cancer Programs, Chicago, Illinois, USA
| | - Amanda Browner
- American College of Surgeons Cancer Programs, Chicago, Illinois, USA
| | - Joseph Cotler
- American College of Surgeons Cancer Programs, Chicago, Illinois, USA
| | - Heidi Nelson
- American College of Surgeons Cancer Programs, Chicago, Illinois, USA
| | - Karla V Ballman
- Department of Population Health Sciences, Division of Biostatistics, Weill Cornell Medicine, New York, New York, USA
| | - Michael LeBlanc
- SWOG Statistics and Data Management Center, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Marc J Gollub
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cathy Eng
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, USA
| | - James D Brierley
- Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Joel M Palefsky
- Department of Medicine, University of California, San Francisco, California, USA
| | - Richard M Goldberg
- West Virginia University Cancer Institute, Morgantown, West Virginia, USA
| | - Karyn A Goodman
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - M Kay Washington
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Elliot A Asare
- Department of Surgery, University of Utah Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Bryan Palis
- American College of Surgeons Cancer Programs, Chicago, Illinois, USA
| |
Collapse
|
25
|
von Samson-Himmelstjerna FA, Kakavand N, Gleske C, Schraml F, Basta AA, Braunisch MC, Bräsen JH, Schmitz J, Kraus D, Weinmann-Menke J, Zacharias HU, Vaulet T, Naesens M, Krautter M, Schwenger V, Esser G, Kolbrink B, Amann K, Holzmann-Littig C, Echterdiek F, Kunzendorf U, Renders L, Schulte K, Heemann U. Potential and Uncertainties of RejectClass in Acute Kidney Graft Dysfunction: An Independent Validation Study. Transplantation 2024; 108:1228-1238. [PMID: 38196094 DOI: 10.1097/tp.0000000000004906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
BACKGROUND Kidney graft rejections are classified based on the Banff classification. The RejectClass algorithm, initially derived from a cohort comprising mostly protocol biopsies, identifies data-driven phenotypes of acute rejection and chronic pathology using Banff lesion scores. It also provides composite scores for inflammation activity and chronicity. This study independently evaluates the performance of RejectClass in a cohort consisting entirely of indication biopsies. METHODS We retrospectively applied RejectClass to 441 patients from the German TRABIO (TRAnsplant BIOpsies) cohort who had received indication biopsies. The primary endpoint was death-censored graft failure during 2 y of follow-up. RESULTS The application of RejectClass to our cohort demonstrated moderately comparable phenotypic features with the derivation cohort, and most clusters indicated an elevated risk of graft loss. However, the reproduction of all phenotypes and the associated risks of graft failure, as depicted in the original studies, was not fully accomplished. In contrast, adjusted Cox proportional hazards analyses substantiated that both the inflammation score and the chronicity score are independently associated with graft loss, exhibiting hazard ratios of 1.7 (95% confidence interval, 1.2-2.3; P = 0.002) and 2.2 (95% confidence interval, 1.8-2.6; P < 0.001), respectively, per 0.25-point increment (scale: 0.0-1.0). CONCLUSIONS The composite inflammation and chronicity scores may already have direct utility in quantitatively assessing the disease stage. Further refinement and validation of RejectClass clusters are necessary to achieve more reliable and accurate phenotyping of rejection.
Collapse
Affiliation(s)
| | - Nassim Kakavand
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Charlotte Gleske
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Schraml
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Agathe A Basta
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Matthias C Braunisch
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Jan H Bräsen
- Nephropathology Unit, Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Jessica Schmitz
- Nephropathology Unit, Department of Pathology, Hannover Medical School, Hannover, Germany
| | - Daniel Kraus
- Department of Nephrology, Department of Internal Medicine 1, University Medical Center Mainz, Mainz, Germany
| | - Julia Weinmann-Menke
- Department of Nephrology, Department of Internal Medicine 1, University Medical Center Mainz, Mainz, Germany
| | - Helena U Zacharias
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, Hannover, Germany
| | - Thibaut Vaulet
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Maarten Naesens
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium
| | - Markus Krautter
- Department of Nephrology, Transplant Center, Klinikum Stuttgart, Stuttgart, Germany
| | - Vedat Schwenger
- Department of Nephrology, Transplant Center, Klinikum Stuttgart, Stuttgart, Germany
| | - Grit Esser
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Benedikt Kolbrink
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Kerstin Amann
- Department of Nephropathology, University Hospital Erlangen, University of Erlangen-Nürnberg, Erlangen, Germany
| | - Christopher Holzmann-Littig
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Fabian Echterdiek
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ulrich Kunzendorf
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Lutz Renders
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Kevin Schulte
- Department of Nephrology and Hypertension, University Hospital Schleswig-Holstein-Campus Kiel, Kiel, Germany
| | - Uwe Heemann
- Department of Nephrology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
26
|
Lu Y, Cen Y, He X, Mo X, Luo F, Zhong Y. Magnetic resonance imaging-based rim enhancement could effectually predict poor prognosis in hepatocellular carcinoma: a meta-analysis. Eur J Gastroenterol Hepatol 2024; 36:505-512. [PMID: 38555599 PMCID: PMC10965130 DOI: 10.1097/meg.0000000000002727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/06/2023] [Indexed: 04/02/2024]
Abstract
Recent studies have initially shown that MRI-based rim enhancement associates with poor prognosis in hepatocellular carcinoma (HCC) patients, but their sample sizes are small, leading to a necessary of comprehensive analyses to make a relatively solid statement. Thus, this meta-analysis aimed to summarize the correlation between MRI-based rim enhancement and prognosis in HCC patients. Until March 2023, a literature search was conducted on Web of Science, PubMed, EMBASE, Cochrane, CNKI, Wangfang, and CQVIP databases in order to identify studies that report the correlation between MRI-based rim enhancement and the prognosis of HCC patients. MRI-based rim enhancement and prognostic data were extracted and analyzed. In our study, eight studies containing 1816 HCC patients were analyzed. Generally, the presence of MRI-based rim enhancement was related to shortened disease-free survival (DFS) [hazard ratio (HR): 2.77, 95% confidence interval (CI): 2.11-3.62, P < 0.001], and worse overall survival (OS) (HR: 5.43, 95% CI: 2.14-13.79, P < 0.001). While no other prognostic data could be retrieved. Funnel plots, Begg's test, and Egger's test all indicated that no publication bias existed; and the risk score by Newcastle-Ottawa Scale criteria ranged from 7-9 points, suggesting a generally low risk of bias. Meanwhile, the sensitivity analysis showed that the significant findings did not change by omitting each study. Then, subgroup analyses revealed that no matter stratified by tumor size, treatment option, or sample size, rim enhancement was linked with unsatisfied DFS (all P < 0.05). Conclusively, MRI-based rim enhancement could effectually estimate poor survival in HCC patients, indicating its good prognostic value.
Collapse
Affiliation(s)
- Yumin Lu
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Yongyi Cen
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Xin He
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Xiaping Mo
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Fang Luo
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Yubao Zhong
- Department of Radiology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| |
Collapse
|
27
|
Johnson KJ, Brown DS, O'Connell CP, Thompson T, Barnes JM, King AA. Associations between Medicaid enrollment and diagnosis stage and survival among pediatric cancer patients. Pediatr Blood Cancer 2024; 71:e30861. [PMID: 38235939 DOI: 10.1002/pbc.30861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/12/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Medicaid-associated disparities in childhood and adolescent (pediatric) cancer diagnosis stage and survival have been reported. However, a key limitation of prior studies is the assessment of health insurance at a single time point. To evaluate Medicaid-associated disparities more robustly, we used Surveillance, Epidemiology, and End Results (SEER)-Medicaid linked data to examine diagnosis stage and survival disparities in those (i) Medicaid-enrolled and (ii) with discontinuous and continuous Medicaid enrollment. METHODS SEER-Medicaid linked data from 2006 to 2013 were obtained on cases diagnosed from 0 to 19 years. Medicaid enrollment was classified as enrolled versus not enrolled, with further classifications as continuous when enrolled 6 months before through 6 months after diagnosis, and discontinuous when not enrolled continuously for this period. We used multinomial logistic and Cox proportional hazards regression models to determine associations between enrollment measures, diagnosis stage, and cancer death adjusted for covariates. RESULTS Among 21,502 cases, a higher odds of distant stage diagnoses were observed in association with Medicaid enrollment (odds ratio [OR] = 1.56, 95% confidence interval [CI]: 1.48-1.65), with the highest odds for discontinuous enrollment (OR = 2.0, 95% CI: 1.86-2.15). Among 30,654 cases, any Medicaid enrollment, continuous enrollment, and discontinuous enrollment were associated with 1.68 (95% CI: 1.35-2.10), 1.66 (95% CI: 1.35-2.05), and 1.89 (95% CI: 1.54-2.33) times higher hazards of cancer death versus no enrollment, respectively. CONCLUSIONS Medicaid enrollment, particularly discontinuous enrollment, is associated with a higher distant stage diagnosis odds and risk of death. This study supports the critical need for consistent health insurance coverage in children and adolescents.
Collapse
Affiliation(s)
- Kimberly J Johnson
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
- Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Derek S Brown
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Tess Thompson
- School of Social Work, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Justin M Barnes
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Allison A King
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pediatrics Hematology/Oncology, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
28
|
Chen Y, Cai XB, Yao X, Zhang SH, Cai MH, Li HP, Jing XB, Zhang YG, Ding QF. Association of serum albumin with heart failure mortality with NYHA class IV in Chinese patients: Insights from PhysioNet database (version 1.3). Heart Lung 2024; 65:72-77. [PMID: 38432040 DOI: 10.1016/j.hrtlng.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/08/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Studies have proved that low albumin level is associated with increased mortality in most diseases, such as chronic kidney disease and hepatic cirrhosis. However, the relationship between albumin and all-cause death in heart failure patients in China is still unclear. OBJECTIVES We aimed to investigate the association between albumin level and 28-day mortality in Chinese hospitalized patients with NYHA IV heart failure. METHODS A total of 2008 Chinese patients were included. The correlation between serum albumin level and mortality was tested using a cox proportional hazards regression model. The smooth curve fitting was used to identify non-linear relationships between serum albumin and mortality. The Forest plot analysis was used to assess the association between albumin and 28-day mortality in different groups. RESULTS Compared with patients with NYHA II-III, patients with NYHA IV had lower albumin level and higher mortality within 28 days. The albumin on admission was independently and inversely associated with the endpoint risk, which remained significant (hazard ratio: 0.80; 95 % confidence interval: 0.66 to 0.96; p = 0.0196) after multivariable adjustment. The smooth curve fitting showed with the increase of albumin, the mortality within 28 days would decrease. A subgroup analysis found that the inverse association between the albumin level and risk of the mortality was consistent across the subgroup stratified by possible influence factors. CONCLUSION Serum albumin level is negatively associated with 28-day mortality in hospitalized heart failure patients within NYHA IV in China, which can be used as an independent predictor.
Collapse
Affiliation(s)
- Yun Chen
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Xian-Bin Cai
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Xin Yao
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Shao-Hui Zhang
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Min-Hua Cai
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Hao-Peng Li
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Xu-Bin Jing
- Department of Gastroenterology, First Affiliated Hospital of Shantou University Medical College, 57 Changping Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Yong-Gang Zhang
- Department of EICU, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxiabei Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China
| | - Qia-Feng Ding
- Department of EICU, Second Affiliated Hospital of Shantou University Medical College, 69 Dongxiabei Road, Shantou 515041, Guangdong, China; Shantou University Medical College, 22 Xinling Road, Shantou 515041, Guangdong, China.
| |
Collapse
|
29
|
Prost P, Duraes M, Georgescu V, Rebel L, Mercier G, Rathat G. Impact of Ovarian Cancer Surgery Volume on Overall and Progression-Free Survival: A Population-Based Retrospective National French Study. Ann Surg Oncol 2024; 31:3269-3279. [PMID: 38393461 DOI: 10.1245/s10434-024-15050-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Data are limited on the relationship between ovarian cancer surgery volume and outcomes in France. METHODS For this retrospective, population-based study, patients with ovarian cancer that was diagnosed between January 1, 2012 and December 31, 2016 were identified from the French National Health Data System (SNDS). Hospitals were classified in function of their ovarian cancer surgery volume. Patient, tumor, hospital, and hospital stay characteristics also were evaluated. The hospital procedure volume effect on 5-year overall survival (OS) and recurrence-free survival (RFS) was determined with Cox-proportional hazards models. RESULTS This study included 8429 patients and 53.4% underwent cytoreductive surgery in hospitals with procedure volume < 20 cases/year. The 5-year OS rates were 63% and 60% in hospitals with procedure volume ≥ 20 and < 20 cases/year (p = 0.02). In multivariate analysis, OS and RFS were significantly increased when surgery was performed in hospitals doing ≥ 20 surgeries/year (vs. < 20) (hazard ratio HR = 1.18, 95% CI = 1.08-1.29 and HR = 1.10, 95% CI = 1.03-1.17). In the volume subgroup analysis, a difference was observed mainly between hospitals with < 10 surgeries/year and the other hospitals (HR = 1.27, 95% CI = 1.14-1.41 and HR = 1.14, 95% CI = 1.05-1.23). The patients' age and comorbidities, tumor stage, and hospital stay (duration, first cytoreduction surgery) were associated with OS. CONCLUSIONS Ovarian cancer surgery volume ≥ 20 cases/year was significantly associated with improved OS and RFS but only with a limited clinical benefit. The biggest differences in OS and RFS were observed between hospitals with procedure volume < 10 cases/year and all the other hospitals.
Collapse
Affiliation(s)
- Pauline Prost
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France.
| | - Martha Duraes
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France
| | - Vera Georgescu
- Health Data Science Unit, Montpellier University Hospital and UMR IDESP, INSERM, Montpellier University, Montpellier, France
| | - Lucie Rebel
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France
| | - Grégoire Mercier
- Health Data Science Unit, Montpellier University Hospital and UMR IDESP, INSERM, Montpellier University, Montpellier, France
| | - Gauthier Rathat
- Department of Gynecological and Breast Surgery, Montpellier University Hospital, Montpellier, France
| |
Collapse
|
30
|
Li S, Zhang L, Yin H, Zhang G, Tan M, Cai Z, Huang T, Lin H, Lyu J. Venous thromboembolism prophylaxis and mortality in patients with spinal fractures in ICUs. Nurs Crit Care 2024; 29:564-572. [PMID: 37041106 DOI: 10.1111/nicc.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Spinal fracture is a common traumatic condition in orthopaedics, accounting for 5%-6% of total body fractures, and is a high-risk factor for venous thromboembolism (VTE), which seriously affects patient prognosis. AIM The aim of this study was to determine the impact of VTE prophylaxis on the prognosis of patients with spinal fractures in intensive care units (ICUs) and to provide a scientific basis for clinical treatment and nursing. DESIGN A retrospective study of patients with spinal fractures from the multicenter eICU Collaborative Research Database. METHOD The outcomes of this study were ICU mortality and in-hospital mortality. Patients were divided into the VTE prophylaxis (VP) and no VTE prophylaxis (NVP) groups according to whether they had undergone VTE prophylaxis during their ICU admission. The association between groups and outcomes were analysed using Kaplan-Meier (KM) survival curve, log-rank test and the Cox proportional-hazards regression model. RESULTS This study included 1146 patients with spinal fractures: 330 in the VP group and 816 in the NVP group. KM survival curves and log-rank tests revealed that both ICU and in-hospital survival probabilities in the VP group were significantly higher than in the NVP group. After the Cox model was adjusted for all covariates, the hazard ratio for ICU mortality in the VP group was 0.38 (0.19-0.75); the corresponding value for in-hospital mortality in the VP group was 0.38 (0.21-0.68). CONCLUSIONS VTE prophylaxis is associated with reduced ICU and in-hospital mortality in patients with spinal fractures in ICUs. More research is necessary to further define specific strategies and optimal timing for VTE prophylaxis. RELEVANCE TO CLINICAL PRACTICE This study provides the basis that VTE prophylaxis may be associated with improved prognosis in patients with spinal fractures in ICUs. In clinical practice, an appropriate modality should be selected for VTE prophylaxis in such patients.
Collapse
Affiliation(s)
- Shaojin Li
- Department of Orthopaedics, The first affiliated hospital of Jinan University Guangzhou, Guangzhou, China
| | - Luming Zhang
- Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Haiyan Yin
- Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Guowei Zhang
- Department of Orthopaedics, The first affiliated hospital of Jinan University Guangzhou, Guangzhou, China
| | - Minghui Tan
- Department of Orthopaedics, The first affiliated hospital of Jinan University Guangzhou, Guangzhou, China
| | - Zhenbin Cai
- Department of Orthopaedics, The first affiliated hospital of Jinan University Guangzhou, Guangzhou, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Hongsheng Lin
- Department of Orthopaedics, The first affiliated hospital of Jinan University Guangzhou, Guangzhou, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| |
Collapse
|
31
|
Hoyos JA, Londoño DR, Hoyos AG, Reyes EC, Varela R, Giraldo JS. Impact of presentation timing in metastatic hormone-sensitive prostate cancer: Characterization of patients and identification of prognostic factors. Prostate 2024; 84:560-569. [PMID: 38311854 DOI: 10.1002/pros.24672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/12/2023] [Accepted: 01/19/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND The treatment and surveillance of metastatic hormone-sensitive prostate cancer (mHSPC) has evolved since the introduction of several treatment intensification options associated with hormonal blockade and classifications based on the timing of metastatic disease presentation and disease volume. Using a hospital-based registry, we aimed to assess whether these new classifications are applicable to our population, as few studies have demonstrated their prognostic value for overall survival (OS) and time to development of castration-resistant prostate cancer (CRPC), and to establish prognostic factors in our population. METHODS A retrospective cohort of mHSPC patients who were attended at an oncology referral hospital in Bogota between 2017 and 2021 were included in this study. The primary and secondary endpoints were OS and time to CRPC. The distribution of outcome measures was estimated using the Kaplan-Meier method. Proportional hazard models were constructed using the Cox regression approach and stratified according to risk factors. RESULTS The study cohort included 373 patients. The median castration resistance-free survival was 48 months (CI: 32-73 months), and OS was 43 months (CI: 37-48 months). In multivariate analysis, nodal staging, ECOG status, and surgical castration were independent prognostic factors. CONCLUSION In our hospital-based registry, the independent impact of the time of presentation on castration-resistant-free survival or OS could not be demonstrated, nor could the grouping of prognostic categories based on metastatic presentation temporality and volume. Other independent prognostic factors have been proposed.
Collapse
Affiliation(s)
- Juliana Arenas Hoyos
- Division of Urology, Pontificia Universidad Javeriana, Hospital Universitario San Igancio, Bogota, Colombia
| | - David Ruiz Londoño
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | - Andres Gomez Hoyos
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | | | - Rodolfo Varela
- Division of Uro-Oncology, Colombian National Cancer Institute, Bogotá, Colombia
| | - Julian Serrano Giraldo
- Division of Urology, Pontificia Universidad Javeriana, Hospital Universitario San Igancio, Bogota, Colombia
| |
Collapse
|
32
|
Lu HR, Zhu PF, Deng YY, Chen ZL, Yang L. Predictive value of NLR and PLR for immune-related adverse events: a systematic review and meta-analysis. Clin Transl Oncol 2024; 26:1106-1116. [PMID: 37682501 DOI: 10.1007/s12094-023-03313-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Currently, there is a lack of affordable and accessible indicators that can accurately predict immune-related adverse events (irAEs) resulting from the use of immune checkpoint inhibitors (ICIs). In order to address this knowledge gap, our study explore the potential predictive value of two ratios, namely the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), for irAEs in cancer patients. METHODS A systematic search was performed in PubMed, Embase, and the Cochrane library. Studies involving NLR or PLR with irAEs were included. Quality and risk of bias of the selected studies were assessed. Forest plots were created based on Cox model analysis. Random effects meta-analyses were conducted to estimate odds ratio (OR) and its 95% confidence interval (CI). RESULTS After screening 594 studies, a total of 7 eligible studies with 1068 cancer patients were included. Analysis based on Cox regression showed that low neutrophil-lymphocyte ratio (L-NLR) (OR = 3.02, 95% CI 1.51 to 6.05, P = 0.002) and low platelet-lymphocyte ratio (L-PLR) (OR = 1.83, 95% CI 1.21 to 2.76, P = 0.004) were associated with irAEs. In the subgroup analysis of cut-off value, when the NLR cut-off value was 3, irAEs was significantly correlated with NLR (OR = 2.63, 95% CI 1.63 to 4.26, P < 0.001). CONCLUSIONS Both L-NLR and L-PLR have been found to be significantly associated with irAEs. Consequently, patients identified as being at a higher risk for irAEs should be subjected to more diligent monitoring and close observation.
Collapse
Affiliation(s)
- Hong-Rui Lu
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, 233000, Anhui Province, China
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China
| | - Peng-Fei Zhu
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, 233000, Anhui Province, China
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China
| | - Ya-Ya Deng
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China
- Graduate Department, Jinzhou Medical University, Jinzhou, 121000, Liaoning, China
| | - Zhe-Ling Chen
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.
| | - Liu Yang
- Graduate School of Clinical Medicine, Bengbu Medical College, Bengbu, 233000, Anhui Province, China.
- Cancer Center, Department of Medical Oncology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, 310014, Zhejiang, China.
- Graduate Department, Jinzhou Medical University, Jinzhou, 121000, Liaoning, China.
| |
Collapse
|
33
|
Reddy J, Schiff D, Terplan M, Jones H, Putnam-Hornstein E. Child Protection System Removal and Short-Interval Births Among Individuals With Prenatal Substance Use. Obstet Gynecol 2024; 143:700-703. [PMID: 38484312 PMCID: PMC11031339 DOI: 10.1097/aog.0000000000005552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 04/20/2024]
Abstract
Child protection systems often intervene after substance-exposed births but are not designed to address the postpartum needs of the delivering parent. In this retrospective cohort study, we aimed to estimate the association between early child protection system removal and high-risk subsequent birth trajectories among a cohort of mothers with substance-exposed births in California. Of 6,893 births in 2015 with documented prenatal drug and alcohol exposure, 20.4% of mothers experienced child protection system removal within 30 days after birth. First-month child protection system removal was associated with short-interval birth (adjusted hazard ratio [HR] 1.61, 95% CI, 1.09-2.36) and short-interval birth with documentation of substance exposure (adjusted HR 3.17, 95% CI, 1.65-6.08). We found that child separation was associated with an increase, not a reduction, in subsequent substance-exposed births. These findings indicate the need for focused public health and supportive services to address the treatment, health care, family-building, and psychological needs of parents with substance use during pregnancy.
Collapse
Affiliation(s)
- Julia Reddy
- Gillings School of Global Public Health, the Department of Obstetrics & Gynecology, and the School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts; and Friends Research Institute, Baltimore, Maryland
| | | | | | | | | |
Collapse
|
34
|
Männistö VT, Hakkarainen K, Jula A, Lundqvist A, Vihervaara T, Erlund I, Åberg F. Serum ferritin level is associated with liver fibrosis and incident liver-related outcomes independent of HFE genotype in the general population. Scand J Gastroenterol 2024; 59:592-599. [PMID: 38329447 DOI: 10.1080/00365521.2024.2314707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/31/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND & AIMS Hyperferritinemia reflects iron accumulation in the body and has been associated with metabolic disturbances and alcohol use, and is also a common finding in individuals diagnosed with liver disease. The major genetic regulator of iron metabolism is the HFE gene. METHODS The aim of this this study was to investigate the association between serum ferritin and liver fibrosis using the enhanced liver fibrosis (ELF) test, and the association between ferritin and liver-related outcomes in a Finnish population-based cohort of 6194 individuals (45% male, mean [± standard deviation] age, 52.9 ± 14.9 years; body mass index 26.9 ± 4.7 kg/m2). The effects of HFE variants on these associations were also evaluated. RESULTS Serum ferritin levels were significantly associated with liver fibrosis, as estimated by enhanced liver fibrosis (ELF) test in weighted linear regression analysis. Serum ferritin was significantly associated with both all liver-related outcomes (n = 92) and severe liver-related outcomes (n = 54) in weighted Cox regression analysis (hazard ratio [HR] per 1 SD, 1.11 [95% confidence interval (CI) 1.02-1.21]; p = 0.012 and HR 1.11 [95% CI 1.02-1.21]; p = 0.013, respectively). However, there was association neither between HFE risk variants and ELF test nor between HFE risk variants and liver-related outcomes. CONCLUSION Serum ferritin levels were associated with liver fibrosis and incident liver disease, independent of HFE genotype in the general population. Furthermore, data demonstrated that metabolic disturbances and alcohol use were major risk factors for hyperferritinemia.
Collapse
Affiliation(s)
- Ville T Männistö
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | | | - Antti Jula
- Finnish Institute for Health and Welfare, Finland
| | | | | | - Iris Erlund
- Finnish Institute for Health and Welfare, Finland
| | - Fredrik Åberg
- Transplantation and Liver Surgery Clinic, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
35
|
Struebing A, McKibbon C, Ruan H, Mackay E, Dennis N, Velummailum R, He P, Tanaka Y, Xiong Y, Springford A, Rosenlund M. Augmenting external control arms using Bayesian borrowing: a case study in first-line non-small cell lung cancer. J Comp Eff Res 2024; 13:e230175. [PMID: 38573331 PMCID: PMC11036906 DOI: 10.57264/cer-2023-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/01/2024] [Indexed: 04/05/2024] Open
Abstract
Aim: This study aimed to improve comparative effectiveness estimates and discuss challenges encountered through the application of Bayesian borrowing (BB) methods to augment an external control arm (ECA) constructed from real-world data (RWD) using historical clinical trial data in first-line non-small-cell lung cancer (NSCLC). Materials & methods: An ECA for a randomized controlled trial (RCT) in first-line NSCLC was constructed using ConcertAI Patient360™ to assess chemotherapy with or without cetuximab, in the bevacizumab-inappropriate subpopulation. Cardinality matching was used to match patient characteristics between the treatment arm (cetuximab + chemotherapy) and ECA. Overall survival (OS) was assessed as the primary outcome using Cox proportional hazards (PH). BB was conducted using a static power prior under a Weibull PH parameterization with borrowing weights from 0.0 to 1.0 and augmentation of the ECA from a historical control trial. Results: The constructed ECA yielded a higher overall survival (OS) hazard ratio (HR) (HR = 1.53; 95% CI: 1.21-1.93) than observed in the matched population of the RCT (HR = 0.91; 95% CI: 0.73-1.13). The OS HR decreased through the incorporation of BB (HR = 1.30; 95% CI: 1.08-1.54, borrowing weight = 1.0). BB was applied to augment the RCT control arm via a historical control which improved the precision of the observed HR estimate (1.03; 95% CI: 0.86-1.22, borrowing weight = 1.0), in comparison to the matched population of the RCT alone. Conclusion: In this study, the RWD ECA was unable to successfully replicate the OS estimates from the matched population of the selected RCT. The inability to replicate could be due to unmeasured confounding and variations in time-periods, follow-up and subsequent therapy. Despite these findings, we demonstrate how BB can improve precision of comparative effectiveness estimates, potentially aid as a bias assessment tool and mitigate challenges of traditional methods when appropriate external data sources are available.
Collapse
Affiliation(s)
| | | | - Haoyao Ruan
- Cytel Inc., Toronto, Ontario, M5J, 2P1, Canada
| | - Emma Mackay
- Cytel Inc., Toronto, Ontario, M5J, 2P1, Canada
| | | | | | - Philip He
- Daiichi Sankyo, Inc., Basking Ridge, NJ 07920, USA
| | - Yoko Tanaka
- Daiichi Sankyo, Inc., Basking Ridge, NJ 07920, USA
| | - Yan Xiong
- Daiichi Sankyo, Inc., Basking Ridge, NJ 07920, USA
| | | | - Mats Rosenlund
- Daiichi Sankyo Europe, Munich, 81379, Germany
- Department of Learning, Informatics, Management & Ethics (LIME), Karolinska Institutet, Stockholm, 171 77, Sweden
| |
Collapse
|
36
|
Liu Q, Zhang Y, Vaselkiv JB, Mucci LA, Giovannucci EL, Platz EA, Sutcliffe S. A prospective study of birth weight and prostate cancer risk and mortality in the Health Professionals Follow-up Study. Br J Cancer 2024; 130:1295-1303. [PMID: 38388857 PMCID: PMC11015033 DOI: 10.1038/s41416-024-02593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Previous studies have observed inconsistent associations between birth weight and aggressive prostate cancer risk. This study aimed to prospectively analyse this association in the Health Professionals Follow-up Study (HPFS). METHODS Birth weight was self-reported in 1994, and prostate cancer diagnoses were assessed biennially through January 2017 and confirmed by medical record review. Multivariable Cox proportional hazards regression was used to evaluate the association between birth weight and prostate cancer risk and mortality. RESULTS Among 19,889 eligible men, 2520 were diagnosed with prostate cancer, including 643 with higher-grade/advanced stage, 296 with lethal, and 248 with fatal disease. Overall, no association was observed for increasing birth weight with risk of overall prostate cancer, lower-grade, and organ-confined disease. However, a borderline statistically significant positive trend was observed for increasing birth weight with risk of higher-grade and/or advanced-stage prostate cancer (adjusted hazard ratio [HRadj] per pound: 1.05; 95% confidence interval [CI]: 0.99-1.11; P-trend = 0.08), but no associations were observed with risk of lethal or fatal disease (HRadj: 0.99, 95% CI: 0.91-1.08; P-trend = 0.83; and HRadj: 0.99, 95% CI: 0.90-1.08; P-trend = 0.82, respectively). CONCLUSION No consistent associations were observed between birth weight and prostate cancer risk or mortality in this 22-year prospective cohort study.
Collapse
Affiliation(s)
- Qinran Liu
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Yiwen Zhang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jane B Vaselkiv
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery; and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
37
|
Park CHK, Kim D, Kim B, Rhee SJ, Cho SJ, Ahn YM. Serum lipids as predictive markers for death by suicide. Psychiatry Res 2024; 335:115837. [PMID: 38492263 DOI: 10.1016/j.psychres.2024.115837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/18/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
Serum lipid levels have been associated with an increased risk of suicidal behaviors. This retrospective cohort study aimed to investigate the association between serum lipid levels and death by suicide among suicide attempters according to sex. Suicide attempters visiting emergency departments between 2007 and 2011 were followed up until the date of all-cause death or December 31, 2012. Sex-stratified Cox proportional hazards regression and competing risk models were constructed to obtain the hazard ratios (HR) of serum lipid measures and suicide. For each significant lipid variable in the final models, Kaplan-Meier survival analysis and cumulative incidence function (CIF) were employed to compare the time to suicide between the high- and low-lipid groups based on the best cutoff point from the receiver operating characteristic curve. In 408 female attempters (65.8 %), the HR in the Cox regression model and subdistribution HR in the competing risk model for increased total cholesterol (TC) were 0.968 and 0.970, respectively. In the Kaplan-Meier survival analysis and CIF, increased death by suicide was demonstrated in the low-TC group (< 165 mg/dL). Lower serum TC levels among female suicide attempters may predict suicide. More careful monitoring is warranted in women with lower TC levels who recently attempted suicide.
Collapse
Affiliation(s)
- C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Republic of Korea.
| | - Daewook Kim
- Haru Psychiatric Clinic, 775-1 Gaya-daero, Busanjin-gu, Busan 47278, Republic of Korea.
| | - Bora Kim
- Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Palo Alto, CA 94305, United States; Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Palo Alto, CA 94304, United States.
| | - Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| | - Sung Joon Cho
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea.
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea; Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
| |
Collapse
|
38
|
Ing C, Silber JH, Lackraj D, Olfson M, Miles C, Reiter JG, Jain S, Chihuri S, Guo L, Gyamfi-Bannerman C, Wall M, Li G. Behavioural disorders after prenatal exposure to anaesthesia for maternal surgery. Br J Anaesth 2024; 132:899-910. [PMID: 38423824 DOI: 10.1016/j.bja.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/27/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The association between prenatal exposure to general anaesthesia for maternal surgery during pregnancy and subsequent risk of disruptive or internalising behavioural disorder diagnosis in the child has not been well-defined. METHODS A nationwide sample of pregnant women linked to their liveborn infants was evaluated using the Medicaid Analytic eXtract (MAX, 1999-2013). Multivariate matching was used to match each child prenatally exposed to general anaesthesia owing to maternal appendectomy or cholecystectomy during pregnancy with five unexposed children. The primary outcome was diagnosis of a disruptive or internalising behavioural disorder in children. Secondary outcomes included diagnoses for a range of other neuropsychiatric disorders. RESULTS We matched 34,271 prenatally exposed children with 171,355 unexposed children in the database. Prenatally exposed children were more likely than unexposed children to receive a diagnosis of a disruptive or internalising behavioural disorder (hazard ratio [HR], 1.31; 95% confidence interval [CI], 1.23-1.40). For secondary outcomes, increased hazards of disruptive (HR, 1.32; 95% CI, 1.24-1.41) and internalising (HR, 1.36; 95% CI, 1.20-1.53) behavioural disorders were identified, and also increased hazards of attention-deficit/hyperactivity disorder (HR, 1.32; 95% CI, 1.22-1.43), behavioural disorders (HR, 1.28; 95% CI, 1.14-1.42), developmental speech or language disorders (HR, 1.16; 95% CI, 1.05-1.28), and autism (HR, 1.31; 95% CI, 1.05-1.64). CONCLUSIONS Prenatal exposure to general anaesthesia is associated with a 31% increased risk for a subsequent diagnosis of a disruptive or internalising behavioural disorder in children. Caution is advised when making any clinical decisions regarding care of pregnant women, as avoidance of necessary surgery during pregnancy can have detrimental effects on mothers and their children.
Collapse
Affiliation(s)
- Caleb Ing
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
| | - Jeffrey H Silber
- Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Deven Lackraj
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Caleb Miles
- Department of Biostatistics, Mailman School of Public Health, New York, NY, USA
| | - Joseph G Reiter
- Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Siddharth Jain
- Center for Outcomes Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stanford Chihuri
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Ling Guo
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Melanie Wall
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Biostatistics, Mailman School of Public Health, New York, NY, USA
| | - Guohua Li
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| |
Collapse
|
39
|
Zhu W, Wu L, Xie W, Zhang G, Gu Y, Hou Y, He Y. Comparison of morbidity and mortality after radical cystectomy between individuals older and younger than 80 years: a systematic review and meta-analysis. Int Urol Nephrol 2024; 56:1525-1535. [PMID: 38095810 DOI: 10.1007/s11255-023-03897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/23/2023] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To compare outcomes related to survival and post-operative complications in individuals older and younger than 80 years with bladder cancer undergoing radical cystectomy (RC). METHODS We conducted a systematic search using three large databases: PubMed, EMBASE, and Scopus. We included observational studies comparing outcomes between individuals older than 80 years and younger patients undergoing RC. The outcomes of interest included overall survival, disease-specific survival, progression-free survival, and risk of post-operative complications. We applied a random effects model for the analysis and reported pooled effect sizes as odds ratios (ORs) or hazards ratios (HRs) along with 95% confidence intervals. RESULTS We analyzed 21 studies. Our results show that individuals older than 80 years had higher risks of mortality at 30 days (OR 2.82; 95% CI 1.97, 4.04), 90 days (OR 3.34; 95% CI 2.61, 4.27), 12 months (HR 3.03; 95% CI 2.64, 3.49), and 24 months (HR 3.54; 95% CI 2.27, 5.50) of the post-operative follow-up than younger individuals. In addition, individuals older than 80 years also had poor 5-year survivals (HR 2.17; 95% CI 1.64, 2.88), an increased risk of 5-year cancer-specific mortality (HR 1.58; 95% CI 1.24, 2.03), poor 5-year recurrence free survivals (HR 1.49; 95% CI 1.07, 2.08), and high complications risks (OR 1.20; 95% CI 1.02, 1.42) when compared to younger patients. CONCLUSION Individuals older than 80 years undergoing RC are likely to have poor survival-related outcomes and increased complications risks. Pre-planned comprehensive geriatric assessments (CGAs) may be needed to offer better peri- and post-operative care to improve the outcomes in this patient population.
Collapse
Affiliation(s)
- Wei Zhu
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Lingfeng Wu
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Wenhua Xie
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Gaoyue Zhang
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Yanqin Gu
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Yansong Hou
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China
| | - Yi He
- Department of Urology, The First Hospital of Jiaxing andThe Affiliated Hospital of Jiaxing University, 1882 Zhonghuan South Road, Jiaxing City, 314000, Zhejiang Province, China.
| |
Collapse
|
40
|
González-Kusjanovic N, Delgado Ochoa B, Vidal C, Campos M. Post-operative complications affect survival in surgically treated metastatic spinal cord compression. Int Orthop 2024; 48:1341-1350. [PMID: 38472466 DOI: 10.1007/s00264-024-06120-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/13/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE The prevalence of metastatic epidural spinal cord compression (MESCC) is increasing globally due to advancements in cancer diagnosis and treatment. Whilst surgery can benefit specific patients, the complication rate can reach up to 34%, with limited reporting on their impact in the literature. This study aims to analyse the influence of major complications on the survival of surgically treated MESCC patients. METHODS Consecutive MESCC patients undergoing surgery and meeting inclusion criteria were selected. Survival duration from decompressive surgery to death was recorded. Perioperative factors influencing survival were documented and analysed. Kaplan-Meier survival analysis at one year compared these factors. Univariate and multivariate Cox proportional hazard regression analyses were performed. Additionally, univariate analysis compared complicated and uncomplicated groups. RESULTS Seventy-five patients were analysed. Median survival for this cohort was 229 days (95% CI 174-365). Surgical complications, low patient performance, and rapid primary tumour growth were significant perioperative variables for survival in multivariate analyses (p < 0.001, p = 0.003, and p = 0.02, respectively) with a hazard ratio of 3.2, 3.6, and 2.1, respectively. Univariate analysis showed no variables associated with complication occurrence. CONCLUSION In this cohort, major surgical complications, patient performance, and primary tumour growth rate were found to be independent factors affecting one year survival. Thus, prioritizing complication prevention and appropriate patient selection is crucial for optimizing survival in this population.
Collapse
Affiliation(s)
- Nicolás González-Kusjanovic
- Orthopaedic Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay, 362, Santiago, Chile
| | - Byron Delgado Ochoa
- Orthopaedic Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay, 362, Santiago, Chile
| | - Catalina Vidal
- Orthopaedic Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay, 362, Santiago, Chile
| | - Mauricio Campos
- Orthopaedic Surgery Department, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay, 362, Santiago, Chile.
| |
Collapse
|
41
|
Vujasinovic M, Elbe P, Ekheden I, Wang QL, Thuresson M, Roelstraete B, Ghazi S, Löhr JM, Ludvigsson JF. Gastrointestinal cancer precursor risk and mortality in pancreatic intraductal papillary mucinous neoplasms: a nationwide cohort study. Scand J Gastroenterol 2024; 59:600-607. [PMID: 38351653 DOI: 10.1080/00365521.2024.2310162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/21/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND AND AIMS Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a precursor of pancreatic cancer. While earlier research has shown a high prevalence of synchronous/metachronous extrapancreatic tumors in IPMN patients, these studies have often been small with retrospective data collection. The aim of the study was to examine absolute and relative risks of non-pancreatic gastrointestinal (GI) cancer precursors and mortality in histologically confirmed IPMN. METHODS Through the nationwide ESPRESSO histopathology cohort, we retrieved data on IPMN between 1965 and 2016. Each index case was matched to ≤5 general population controls. Through Cox regression, we estimated hazard ratios (HRs) for future GI cancer precursors and death. RESULTS A total of 117 patients with IPMN and 539 age- and sex-matched controls were included. Over a median of 2.1 years of follow up, we confirmed two (1.7%) incident GI cancer precursors in IPMN vs. four (0.7%) in controls, corresponding to an HR of 1.89 (95%CI = 0.34-10.55). By contrast, IPMN patients were at increased risk of death (HR 3.61 (95%CI = 1.79-7.27)). The most common cause of death in IPMN was pancreatic cancer (n = 14; 45.2% of all deaths). CONCLUSIONS We found no association between IPMN and other GI cancer precursors. This argues against comprehensive routine surveillance for other GI cancer precursors in IPMN patients. Mortality was increased in IPMN with pancreatic cancer being the most common cause of death, indicating the need for lifelong follow up in all resected and non-resected patients with IPMN. However, results should be confirmed in larger cohorts.
Collapse
Affiliation(s)
- Miroslav Vujasinovic
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Peter Elbe
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Isabella Ekheden
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Qiao-Li Wang
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | | | - Bjorn Roelstraete
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sam Ghazi
- Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - J-Matthias Löhr
- Department of Upper Abdominal Diseases, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Celiac Disease Center, Department of Medicine, Columbia University Medical Center, NY, NY, USA
- Department of Pediatrics, Örebro University Hospital, Örebro University, Örebro, Sweden
| |
Collapse
|
42
|
Hoyt M, Song Y, Gao S, O'Palka J, Zhang J. Associations between Two Dietary Quality Scores and Pancreatic Cancer Risk in a US National Prospective Cohort Study. J Am Nutr Assoc 2024; 43:345-355. [PMID: 38096044 DOI: 10.1080/27697061.2023.2289520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/26/2023] [Indexed: 04/25/2024]
Abstract
OBJECTIVE Most previous studies investigated the associations between intake of individual nutrients and risk of disease, which failed to consider the potential interactions and correlations between various nutrients contained in food. Although dietary quality scores provide a comprehensive evaluation of the entire diet, it remains elusive whether they are associated with the risk of pancreatic cancer. METHODS Dietary intake data collected with the Dietary Questionnaire (DQX) and Diet History Questionnaire (DHQ) were used to calculate HEI-2015 and DQI-R scores for participants in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. A high score indicates an increased intake of adequacy components and a decreased intake of moderation components. This study included 252 cases of pancreatic cancer documented from 58,477 persons during a median follow-up of 12.2 years in the DQX cohort and 372 cases of pancreatic cancer ascertained from 101,721 persons during a median follow-up of 8.9 years in the DHQ cohort. Cox proportional hazards regression analysis was performed to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the associations between the two dietary quality scores and pancreatic cancer risk. RESULTS After adjustment for confounders, HEI-2015 and DQI-R scores were not significantly associated with pancreatic cancer risk. However, a significantly lower risk was observed for overweight persons with a higher HEI-2015 score in the DQX cohort (HR [95% CI] comparing the highest with lowest tertile: 0.52 [0.32, 0.85], p for trend = 0.009) and those with higher scores of some individual components. CONCLUSION Collectively, overall dietary quality is not associated with an altered risk of pancreatic cancer in this US population.
Collapse
Affiliation(s)
- Margaret Hoyt
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Yiqing Song
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Sujuan Gao
- Department of Biostatistics and Health Data Science, Indiana University Richard M. Fairbanks School of Public Health and School of Medicine, Indianapolis, IN, USA
| | - Jacquelynn O'Palka
- Department of Nutrition and Dietetics, Indiana University School of Health and Human Sciences, Indianapolis, IN, USA
| | - Jianjun Zhang
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| |
Collapse
|
43
|
Han K, Colson-Fearon D, Liu ZA, Viswanathan AN. Updated Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States: A Surveillance, Epidemiology, and End-Results Study. Int J Radiat Oncol Biol Phys 2024; 119:143-153. [PMID: 37951548 PMCID: PMC11023766 DOI: 10.1016/j.ijrobp.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/08/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE Our previous Surveillance, Epidemiology, and End Results (SEER) study revealed a concerning decline in brachytherapy utilization in the United States between 1988 and 2009. This study evaluates recent trends in brachytherapy utilization in cervical cancer and identifies factors and survival benefit associated with the use of brachytherapy treatment. METHODS AND MATERIALS Using SEER data, 8500 patients with International Federation of Gynecologists and Obstetricians 2009 stage IB2-IVA cervical cancer treated with external beam radiation therapy (EBRT) between 2000 and 2020 were identified. Logistic regression analysis was performed on potential factors associated with brachytherapy use: age, marital status, race, ethnicity, income, metropolitan status, year of diagnosis, SEER region, histology, grade, and stage. To adjust for differences between patients who received brachytherapy and those who did not, propensity-score matching was used. Multivariable Cox regression analysis assessed the association of brachytherapy use with cervical cancer-specific mortality (CSM) and all-cause mortality (ACM) in the matched cohort. RESULTS Sixty-four percent of the 8500 women received brachytherapy in combination with EBRT; 36% received EBRT alone. The brachytherapy utilization rate declined sharply in 2003/2004 (lowest rate 44% in 2003) and then gradually improved especially in 2018 to 2020 (76%). Factors associated with higher odds of brachytherapy use included younger age, married (vs single), later years of diagnosis, certain SEER regions, and earlier stage. In the propensity-score matched cohort, brachytherapy treatment was associated with lower 4-year cumulative incidence of cancer death (32.1% vs 43.4%; P < .001) and better overall survival (64.0% vs 51.4%; P < .001). Brachytherapy treatment was independently associated with lower CSM (hazard ratio, 0.70; 95% CI, 0.64-0.76; P < .001) and ACM (hazard ratio, 0.72; 95% CI, 0.67-0.78; P < .001). CONCLUSIONS Brachytherapy utilization among SEER regions has improved since 2004 in patients with stage IB2-IVA cervical cancer. Brachytherapy use remains independently associated with significantly lower CSM and ACM and is an essential component of treatment for patients with locally advanced cervical cancer.
Collapse
Affiliation(s)
- Kathy Han
- Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, Ontario, Canada.
| | | | - Zhihui Amy Liu
- Department of Biostatistics, University Health Network, Toronto, Ontario, Canada
| | - Akila N Viswanathan
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
44
|
Thao LTP, Wolfe R, Heritier S, Geskus R. Handling missing disease information due to death in diseases that need two visits to diagnose. Stat Med 2024; 43:1708-1725. [PMID: 38382112 DOI: 10.1002/sim.10038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/17/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
In studies that assess disease status periodically, time of disease onset is interval censored between visits. Participants who die between two visits may have unknown disease status after their last visit. In this work, we consider an additional scenario where diagnosis requires two consecutive positive tests, such that disease status can also be unknown at the last visit preceding death. We show that this impacts the choice of censoring time for those who die without an observed disease diagnosis. We investigate two classes of models that quantify the effect of risk factors on disease outcome: a Cox proportional hazards model with death as a competing risk and an illness death model that treats disease as a possible intermediate state. We also consider four censoring strategies: participants without observed disease are censored at death (Cox model only), the last visit, the last visit with a negative test, or the second last visit. We evaluate the performance of model and censoring strategy combinations on simulated data with a binary risk factor and illustrate with a real data application. We find that the illness death model with censoring at the second last visit shows the best performance in all simulation settings. Other combinations show bias that varies in magnitude and direction depending on the differential mortality between diseased and disease-free subjects, the gap between visits, and the choice of the censoring time.
Collapse
Affiliation(s)
- Le Thi Phuong Thao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Stephane Heritier
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ronald Geskus
- Centre for Tropical Medicine and Global Health, Oxford University, Oxford, Oxfordshire, UK
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| |
Collapse
|
45
|
Wang C, Du M. Martingale-residual-based greedy model averaging for high-dimensional current status data. Stat Med 2024; 43:1726-1742. [PMID: 38381059 DOI: 10.1002/sim.10037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/08/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024]
Abstract
Current status data are a type of failure time data that arise when the failure time of study subject cannot be determined precisely but is known only to occur before or after a random monitoring time. Variable selection methods for the failure time data have been discussed extensively in the literature. However, the statistical inference of the model selected based on the variable selection method ignores the uncertainty caused by model selection. To enhance the prediction accuracy for risk quantities such as survival probability, we propose two optimal model averaging methods under semiparametric additive hazards models. Specifically, based on martingale residuals processes, a delete-one cross-validation (CV) process is defined, and two new CV functional criteria are derived for choosing model weights. Furthermore, we present a greedy algorithm for the implementation of the techniques, and the asymptotic optimality of the proposed model averaging approaches is established, along with the convergence of the greedy averaging algorithms. A series of simulation experiments demonstrate the effectiveness and superiority of the proposed methods. Finally, a real-data example is provided as an illustration.
Collapse
Affiliation(s)
- Chang Wang
- School of Mathematics, Jilin University, Changchun, China
| | - Mingyue Du
- School of Mathematics, Jilin University, Changchun, China
| |
Collapse
|
46
|
Chung Y, Ivanova A, Fine JP. Shape restricted additive hazards models: Monotone, unimodal, and U-shape hazard functions. Stat Med 2024; 43:1671-1687. [PMID: 38634251 DOI: 10.1002/sim.10040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 04/19/2024]
Abstract
We consider estimation of the semiparametric additive hazards model with an unspecified baseline hazard function where the effect of a continuous covariate has a specific shape but otherwise unspecified. Such estimation is particularly useful for a unimodal hazard function, where the hazard is monotone increasing and monotone decreasing with an unknown mode. A popular approach of the proportional hazards model is limited in such setting due to the complicated structure of the partial likelihood. Our model defines a quadratic loss function, and its simple structure allows a global Hessian matrix that does not involve parameters. Thus, once the global Hessian matrix is computed, a standard quadratic programming method can be applicable by profiling all possible locations of the mode. However, the quadratic programming method may be inefficient to handle a large global Hessian matrix in the profiling algorithm due to a large dimensionality, where the dimension of the global Hessian matrix and number of hypothetical modes are the same order as the sample size. We propose the quadratic pool adjacent violators algorithm to reduce computational costs. The proposed algorithm is extended to the model with a time-dependent covariate with monotone or U-shape hazard function. In simulation studies, our proposed method improves computational speed compared to the quadratic programming method, with bias and mean square error reductions. We analyze data from a recent cardiovascular study.
Collapse
Affiliation(s)
- Yunro Chung
- College of Health Solutions, Arizona State University, Tempe, Arizona, USA
- Center for Personalized Diagnostics, Biodesign Institute, Arizona State University, Tempe, Arizona, USA
| | - Anastasia Ivanova
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jason P Fine
- Department of Statistics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
47
|
Perurena-Prieto J, Callejas-Moraga EL, Sanz-Martínez MT, Colobran R, Guillén-Del-Castillo A, Simeón-Aznar CP. Prognostic value of anti-IFI16 autoantibodies in pulmonary arterial hypertension and mortality in patients with systemic sclerosis. Med Clin (Barc) 2024; 162:370-377. [PMID: 38302398 DOI: 10.1016/j.medcli.2023.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVES To determine the diagnostic value of anti-interferon gamma inducible protein 16 (IFI16) autoantibodies in systemic sclerosis (SSc) patients negative for all tested SSc-specific autoantibodies (SSc-seronegative patients) and to evaluate the clinical significance of these autoantibodies, whether isolated or in the presence of anti-centromere autoantibodies (ACA). METHODS Overall, 58 SSc-seronegative and 66 ACA-positive patients were included in the study. All patients were tested for anti-IFI16 autoantibodies by an in-house direct ELISA. Associations between clinical parameters and anti-IFI16 autoantibodies were analysed. RESULTS Overall, 17.2% of SSc-seronegative and 39.4% of ACA-positive patients were positive for anti-IFI16 autoantibodies. Anti-IFI16 autoantibodies were found only in patients within the limited cutaneous SSc (lcSSc) subset. A positive association between anti-IFI16 positivity and isolated pulmonary arterial hypertension (PAH) was found (odds ratio [OR]=5.07; p=0.014) even after adjusting for ACA status (OR=4.99; p=0.019). Anti-IFI16-positive patients were found to have poorer overall survival than negative patients (p=0.032). Cumulative survival rates at 10, 20 and 30 years were 96.9%, 92.5% and 68.7% for anti-IFI16-positive patients vs. 98.8%, 97.0% and 90.3% for anti-IFI16-negative-patients, respectively. Anti-IFI16-positive patients also had worse overall survival than anti-IFI16-negative patients after adjusting for ACA status in the multivariate Cox analysis (hazard ratio [HR]=3.21; p=0.043). CONCLUSION Anti-IFI16 autoantibodies were associated with isolated PAH and poorer overall survival. Anti-IFI16 autoantibodies could be used as a supplementary marker of lcSSc in SSc-seronegative patients and for identifying ACA-positive patients with worse clinical outcome.
Collapse
Affiliation(s)
- Janire Perurena-Prieto
- Immunology Division, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Translational Immunology Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona (UAB), Bellaterra, Spain
| | | | - María T Sanz-Martínez
- Immunology Division, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Roger Colobran
- Immunology Division, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Translational Immunology Group, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona (UAB), Bellaterra, Spain; Department of Clinical and Molecular Genetics, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
| | - Alfredo Guillén-Del-Castillo
- Systemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.
| | - Carmen P Simeón-Aznar
- Systemic Autoimmune Diseases Unit, Internal Medicine Department, Vall d'Hebron University Hospital (HUVH), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| |
Collapse
|
48
|
Li X, Gao YH, Yang Z, Ma Y, Liu C, Liu GC, Wang DB. [Establishment of a prognostic nomogram and discussion on optimal treatment for cervical adenocarcinoma:a retrospective study based on SEER database and Chinese single-center data]. Zhonghua Fu Chan Ke Za Zhi 2024; 59:307-319. [PMID: 38644277 DOI: 10.3760/cma.j.cn112141-20231101-00172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To establish and validate a predicting nomogram for cervical adenocarcinoma based on surveillance, epidemiology and end results (SEER) database and Chinese single-center data, and to explore the optimal treatment for cervical adenocarcinoma. Methods: This study selected 2 478 cervical adenocarcinoma patients from the SEER database as the training cohort, and 195 cervical adenocarcinoma patients from Cancer Hospital of Dalian University of Technology, Liaouing Cancer Hospital and Institute as an external validation cohort. Clinicopathological information and follow-up data of the two cohorts were collected. The radiotherapy group was defined as receiving comprehensive treatment based on concurrent chemoradiotherapy after initial diagnosis, while the surgery group was defined as receiving comprehensive treatment based on radical surgery. Log-rank test and cox regression were used to evaluate factors affecting the prognosis of cervical adenocarcinoma patients. A nomogram was drawn to predict the 3-year and 5-year overall survival rates of cervical adenocarcinoma patients, and then internal validation of the training cohort from SEER database and external validation of the hospital cohort were conducted. Results: (1) In the SEER database training cohort, there were 385 patients (15.54%, 385/2 478) in the radiotherapy group and 2 093 patients (84.46%, 2 093/2 478) in the surgery group. Overall survival time of the radiotherapy group was (55.8±51.3) months, while that of the surgery roup was (94.4±61.7) months, the difference between the two groups was statistically significant (χ2=256.44, P<0.001). Log-rank test showed that age, marital status, maximum of tumor diameters, pathological grade, International Federation of Gynecology and Obstetrics (FIGO) stage, and treatments were all significant factors affecting the overall survival time of cervical adenocarcinoma patients (all P<0.001). Multivariate Cox regression analysis showed that elder (>50 years old), single status, huge tumors (>4 cm), high pathological grades (G2, G3), and advanced FIGO stages (≥Ⅱa2 stage) were independent risk factors for the overall survival time of cervical adenocarcinoma patients (all P<0.05); compared with radiotherapy, surgery was a protective factor for the prognosis of cervical adenocarcinoma patients (HR=0.619, 95%CI: 0.494-0.777; P<0.001). Further analysis of locally advanced stage and Ⅲc stage of patients showed that surgery was a protective factor for the prognosis of cervical adenocarcinoma patients with a maximum tumor diameter >4 to <6 cm (HR=0.414, 95%CI: 0.182-0.942; P=0.036) in locally advanced stage and Ⅲc T1 to T2 stage (HR=0.473, 95%CI: 0.307-0.728; P=0.001). (2) The external validation cohort consisted of 39 patients (20.00%, 39/195) in the radiotherapy group and 156 patients (80.00%, 156/195) in the surgery group. The overall survival time of patients in the radiotherapy group was (51.7±34.3) months, while that of the surgery group was (63.1±26.6) months (χ2=28.41, P<0.001). Further analysis was conducted on locally advanced stage and Ⅲc stage patients, and multivariate Cox regression analysis was performed after propensity score matching, which showed that surgery was a protective factor for the prognosis of cervical adenocarcinoma patients with a maximum tumor diameter >4 to <6 cm in locally advanced stage (HR=0.141, 95%CI: 0.023-0.843; P=0.032) and Ⅲc T1 to T2 stage (HR=0.184, 95%CI: 0.036-0.947; P=0.043). (3) Establishment and internal and external validation of nomogram: based on the six factors screened out by the multivariate Cox regression model, the nomogram was developed to predict the prognosis of cervical adenocarcinoma patients. The consistency index of the internal and external validation were 0.801 and 0.766, respectively, and the calibration curves matched well with the ideal fitting line. Conclusions: The key to the treatment of cervical adenocarcinoma is to prioritize radical surgery for patients with conditions for radical tumor resection. Compared with concurrent chemoradiotherapy, patients with locally advanced stages (Ⅰb3, Ⅱa2), and Ⅲc (T1, T2) stages cervical adenocarcinoma could benefit from comprehensive treatment based on radical surgery. The nomogram of this study has been validated internally and externally, and show good survival prediction efficacy for cervical adenocarcinoma patients.
Collapse
Affiliation(s)
- X Li
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - Y H Gao
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - Z Yang
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - Y Ma
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - C Liu
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - G C Liu
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| | - D B Wang
- Department of Gynecology, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital and Institute, Shenyang 110801, China
| |
Collapse
|
49
|
Zhang SY, Gao SQ, Wang ZY, Wu M, Tian Z, Zhang SY. [Analysis of long-term prognosis and risk factors in patients with dilated cardiomyopathy]. Zhonghua Xin Xue Guan Bing Za Zhi 2024; 52:384-390. [PMID: 38644253 DOI: 10.3760/cma.j.cn112148-20231214-00497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objective: To investigate the risk factors and long-term prognosis of major adverse cardiovascular events(MACEs) in patients with dilated cardiomyopathy (DCM). Methods: This study was a single-center retrospective cohort study. Clinical information from 300 patients with DCM hospitalized in Peking Union Medical College Hospital from April 2013 to April 2023 was collected. Based on echocardiography results, the patients were divided into two groups: isolated DCM and DCM with left ventricular non-compaction cardiomyopathy (LVNC). The MACEs, including major heart failure events, severe ventricular arrhythmias, and cardiovascular death, were recorded by outpatient or telephone follow-up. Univariate and multivariate Cox proportional hazard regression models were used to analyze the risk factors affecting the prognosis of patients with DCM. Kaplan-Meier curve and log-rank were used for survival analysis to compare the difference in the incidence of cardiovascular events between the two groups. Results: The included 300 DCM patients were (47.8±16.8) years old, with 197 males (65.7%), of which 237 (79.0%) were isolated DCM and 63 (21.0%) were DCM with LVNC. The follow-up time was 4.0 (1.9, 6.2) years. A total of 142 (47.3%) MACEs occurred, including 117 (39.0%) major heart failure events, 20 (6.7%) severe ventricular arrhythmia events, and 53 (17.7%) cardiovascular death events. Multivariate Cox proportional hazard regression analysis showed that increased left ventricular end-diastolic diameter (HR=1.21, 95%CI: 1.01-1.44, P=0.042), moderate or severe mitral regurgitation (HR=1.71, 95%CI: 1.19-2.47, P=0.004), increased ln (N-terminal pro-B-type natriuretic peptide) (HR=1.30, 95%CI: 1.10-1.54, P=0.002) were independent risk factors for dverse cardiovascular events in DCM patients, and angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB)/angiotensin receptor neprilysin inhibitor (ARNI) treatment (HR=0.45, 95%CI: 0.26-0.78, P=0.004) was independent protective factor. Kaplan-Meier survival analysis found no significant difference in the risk of MACEs between isolated DCM and DCM with LVNC (P=0.22). Similarly, there were no significant differences in the incidence of major heart failure, severe ventricular arrhythmia, and cardiovascular death between the two groups (all P>0.05). Conclusion: An increase in left ventricular end-diastolic diameter, moderate or severe mitral regurgitation, elevated N-terminal pro-B-type natriuretic peptide, and non use of ACEI/ARB/ARNI are independent predictors of cardiovascular events in DCM patients. There was no significant risk of MACEs in patients with isolated DCM and DCM with LVNC, and suggested that LVNC may be a unique phenotype and should be accurately managed in combination with genetic background.
Collapse
Affiliation(s)
- S Y Zhang
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - S Q Gao
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z Y Wang
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - M Wu
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Z Tian
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - S Y Zhang
- Department of Cardiology, State Key Laboratory of Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| |
Collapse
|
50
|
Kitabayashi K, Yamamoto S, Narita I. Appropriate Anthropometric Indices for Geriatric Nutritional Risk Index in Predicting Mortality in Older Japanese Patients: A Comparison of the Lorentz Formula and Body Mass Index. TOHOKU J EXP MED 2024; 262:221-228. [PMID: 38220167 DOI: 10.1620/tjem.2024.j001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The Geriatric Nutritional Risk Index (GNRI) is a popular nutritional screening tool. However, the calculation of ideal body weight (IBW) differs among studies. We aimed to compare GNRI calculated using the Lorentz formula (LF) with a body mass index (BMI) and to investigate the cutoffs based on original or quartile criteria for the association with mortality in elderly patients in Japan. This retrospective study enrolled patients aged 65 and older in a long-term care hospital. The GNRI was calculated using two different IBW methods: the LF and a BMI of 22 kg/m2. We categorized GNRI results based on the original criteria or quartile criteria. Mortality outcomes were analyzed using the GNRI based on IBW (LF or BMI) and its classification (original criteria or quartile) through Cox proportional hazard regression. There were 262 participants, including 160 women, with a median age of 86. There was a notable difference between GNRI-BMI and GNRI-LF. The GNRI-LF original and quartile criteria did not show an association with mortality. A significant association with mortality was found between Q1 and Q4 in the GNRI-BMI quartile criteria (hazard ratio: 2.60; 95% confidence interval: 1.66-4.07, p < 0.01), but not the GNRI-BMI original criteria. The GNRI calculated using BMI with quartile criteria proved to be a reliable predictor of mortality for Japanese elderly inpatients. The calculation method of GNRI and the appropriate cutoff point should be considered based on the patient's background.
Collapse
Affiliation(s)
- Kou Kitabayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
- Shinkohkai Murakami Kinen Hospital
| | - Suguru Yamamoto
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
| | - Ichiei Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences
| |
Collapse
|