Impact of Preoperative Social Frailty on Overall Survival and Cancer-Specific Survival among Older Patients with Gastrointestinal Cancer

2021 ◽  
Author(s):  
Rei Ono ◽  
Daisuke Makiura ◽  
Tetsu Nakamura ◽  
Maho Okumura ◽  
Akimasa Fukuta ◽  
...  
Keyword(s):  
Overall Survival ◽  
Gastrointestinal Cancer ◽  
Older Patients ◽  
Cancer Specific Survival

scholarly journals Effect of Intravesical Chemotherapy on the Survival of Patients with Non-Muscle-Invasive Bladder Cancer Undergoing Transurethral Resection: A Retrospective Cohort Study Among Older Adults

2021 ◽  
Vol 14 (1) ◽  
pp. 20-25
Author(s):  
Ashis K. Das ◽  
Devi K. Mishra ◽  
Saji S. Gopalan
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Older Patients ◽  
P Value ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Muscle Invasive ◽  
Overall Mortality

Background: The average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes. Results: A total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34). Conclusion: Chemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on the survival of older patients with NMIBC that have undergone TURBT.

scholarly journals Effect of intravesical chemotherapy on the survival of patients with non-muscle-invasive bladder cancer undergoing transurethral resection: a retrospective cohort study among older adults

2021 ◽  
Author(s):  
Ashis Kumar Das ◽  
Devi Kalyan Mishra ◽  
Saji Saraswathy Gopalan
Keyword(s):  
Overall Survival ◽  
Bladder Cancer ◽  
Older Patients ◽  
P Value ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Specific Survival ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Muscle Invasive ◽  
Overall Mortality

AbstractBackgroundThe average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT.MethodsUsing the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes.ResultsA total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34).ConclusionChemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on survival of older patients with NMIBC that have undergone TURBT.

scholarly journals Nomograms predicting overall survival and cancer-specific survival for patients with appendiceal cancer after surgery

All Life ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 428-440
Author(s):  
Yuan Zhou ◽  
Dan Wang ◽  
Chongshun Liu ◽  
Tingyu Yan ◽  
Chenglong Li ◽  
...  
Keyword(s):  
Overall Survival ◽  
Appendiceal Cancer ◽  
Cancer Specific Survival

scholarly journals Dynamic nomograms combining N classification with ratio-based nodal classifications to predict long-term survival for patients with lung adenocarcinoma after surgery: a SEER population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suyu Wang ◽  
Yue Yu ◽  
Wenting Xu ◽  
Xin Lv ◽  
Yufeng Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lung Adenocarcinoma ◽  
External Validation ◽  
Predictive Performance ◽  
Information Criterion ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Concordance Index ◽  
Cancer Specific Survival ◽  
Decision Curve Analysis

Abstract Background The prognostic roles of three lymph node classifications, number of positive lymph nodes (NPLN), log odds of positive lymph nodes (LODDS), and lymph node ratio (LNR) in lung adenocarcinoma are unclear. We aim to find the classification with the strongest predictive power and combine it with the American Joint Committee on Cancer (AJCC) 8th TNM stage to establish an optimal prognostic nomogram. Methods 25,005 patients with T1-4N0–2M0 lung adenocarcinoma after surgery between 2004 to 2016 from the Surveillance, Epidemiology, and End Results database were included. The study cohort was divided into training cohort (13,551 patients) and external validation cohort (11,454 patients) according to different geographic region. Univariate and multivariate Cox regression analyses were performed on the training cohort to evaluate the predictive performance of NPLN (Model 1), LODDS (Model 2), LNR (Model 3) or LODDS+LNR (Model 4) respectively for cancer-specific survival and overall survival. Likelihood-ratio χ2 test, Akaike Information Criterion, Harrell concordance index, integrated discrimination improvement (IDI) and net reclassification improvement (NRI) were used to evaluate the predictive performance of the models. Nomograms were established according to the optimal models. They’re put into internal validation using bootstrapping technique and external validation using calibration curves. Nomograms were compared with AJCC 8th TNM stage using decision curve analysis. Results NPLN, LODDS and LNR were independent prognostic factors for cancer-specific survival and overall survival. LODDS+LNR (Model 4) demonstrated the highest Likelihood-ratio χ2 test, highest Harrell concordance index, and lowest Akaike Information Criterion, and IDI and NRI values suggested Model 4 had better prediction accuracy than other models. Internal and external validations showed that the nomograms combining TNM stage with LODDS+LNR were convincingly precise. Decision curve analysis suggested the nomograms performed better than AJCC 8th TNM stage in clinical practicability. Conclusions We constructed online nomograms for cancer-specific survival and overall survival of lung adenocarcinoma patients after surgery, which may facilitate doctors to provide highly individualized therapy.

scholarly journals Nomograms predicting the overall survival and cancer-specific survival of patients with stage IIIC1 cervical cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yifan Feng ◽  
Ye Wang ◽  
Yangqin Xie ◽  
Shuwei Wu ◽  
Yuyang Li ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Random Sampling ◽  
Tumour Size ◽  
Training Group ◽  
Data Sets ◽  
Prognostic Variables ◽  
Cancer Specific Survival ◽  
External Data ◽  
Seer Data

Abstract Background To explore the factors that affect the prognosis of overall survival (OS) and cancer-specific survival (CSS) of patients with stage IIIC1 cervical cancer and establish nomogram models to predict this prognosis. Methods Data from patients in the Surveil-lance, Epidemiology, and End Results (SEER) programme meeting the inclusion criteria were classified into a training group, and validation data were obtained from the First Affiliated Hospital of Anhui Medical University from 2010 to 2019. The incidence, Kaplan-Meier curves, OS and CSS of patients with stage IIIC1 cervical cancer in the training group were evaluated. Nomograms were established according to the results of univariate and multivariate Cox regression models. Harrell’s C-index, calibration plots, receiver operating characteristic (ROC) curves and decision-curve analysis (DCA) were calculated to validate the prediction models. Results The incidence of pelvic lymph node metastasis, a high-risk factor for the prognosis of cervical cancer, decreased slightly over time. Eight independent prognostic variables were identified for OS, including age, race, marriage status, histology, extension range, tumour size, radiotherapy and surgery, but only seven were identified for CSS, with marriage status excluded. Nomograms of OS and CSS were established based on the results. The C-indexes for the nomograms of OS and CSS were 0.687 and 0.692, respectively, using random sampling of SEER data sets and 0.701 and 0.735, respectively, using random sampling of external data sets. The AUCs for the nomogram of OS were 0.708 and 0.705 for the SEER data sets and 0.750 and 0.750 for the external data sets, respectively. In addition, AUCs of 0.707 and 0.709 were obtained for the nomogram of CSS when validated using SEER data sets, and 0.788 and 0.785 when validated using external data sets. Calibration plots for the nomograms were almost identical to the actual observations. The DCA also indicated the value of the two models. Conclusions Eight independent prognostic variables were identified for OS. The same factors predicted CSS, with the exception of the marriage status. Both OS and CSS nomograms had good predictive and clinical application value after validation. Notably, tumour size had the largest contribution to the OS and CSS nomograms.

Considerations in Surgical Management of Gastrointestinal Cancer in Older Patients

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Nicole M. Saur ◽  
Isacco Montroni ◽  
Riccardo A. Audisio
Keyword(s):  
Surgical Management ◽  
Gastrointestinal Cancer ◽  
Older Patients

Neoadjuvant chemoradiation is associated with improved overall survival in older patients with esophageal cancer

2018 ◽  
Vol 9 (1) ◽  
pp. 40-46 ◽  
Author(s):  
David M. Guttmann ◽  
Nandita Mitra ◽  
James M. Metz ◽  
John Plastaras ◽  
Weiwei Feng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Older Patients ◽  
Neoadjuvant Chemoradiation
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