scholarly journals Prediction of cancer-specific survival and overall survival in middle-aged and older patients with rectal adenocarcinoma using a nomogram model

2021 ◽  
Vol 14 (1) ◽  
pp. 100938
Author(s):  
Hao Liu ◽  
Liang Lv ◽  
Yidan Qu ◽  
Ziweng Zheng ◽  
Junjiang Zhao ◽  
...  
Keyword(s):  
Overall Survival ◽  
Older Patients ◽  
Rectal Adenocarcinoma ◽  
Middle Aged ◽  
Cancer Specific Survival

Prognostic factors of overall survival and cancer-specific survival in patients with resected early-stage rectal adenocarcinoma: a SEER-based study

2017 ◽  
Vol 65 (8) ◽  
pp. 1148-1154 ◽  
Author(s):  
Ko-Chao Lee ◽  
Kuan-Chih Chung ◽  
Hong-Hwa Chen ◽  
Chia-Cheng Liu ◽  
Chien-Chang Lu
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Early Stage ◽  
Multivariable Analysis ◽  
Rectal Adenocarcinoma ◽  
Signet Ring Cell ◽  
Postoperative Radiation Therapy ◽  
Cancer Specific Survival ◽  
Tumor Deposit ◽  
The Impact

The benefits of radiotherapy for colorectal cancer are well documented, but the impact of adjuvant radiotherapy on early-stage rectal adenocarcinoma remains unclear. This study aimed to identify predictors of overall survival (OS) and cancer-specific survival (CSS) in patients with stage II rectal adenocarcinoma treated with preoperative or postoperative radiation therapy. Patients with early-stage rectal adenocarcinoma in the postoperative state were identified using the Surveillance, Epidemiology, and End Results database. The primary endpoints were OS and overall CSS. Stage IIA patients without radiotherapy had significantly lower OS and CSS compared with those who received radiation before or after surgery. Stage IIB patients with radiotherapy before surgery had significantly higher OS and CSS compared with patients in the postoperative or no radiotherapy groups. Patients with signet ring cell carcinoma had the poorest OS among all the groups. Multivariable analysis showed that ethnicity (HR, 0.388, p=0.006) and radiation before surgery (HR, 0.614, p=0.006) were favorable prognostic factors for OS, while age (HR, 1.064, p<0.001), race (HR, 1.599, p=0.041), stage IIB (HR, 3.011, p=0.011), and more than one tumor deposit (TD) (HR, 2.300, p=0.001) were unfavorable prognostic factors for OS. Old age (HR, 1.047, p<0.00 L), stage IIB (HR, 8.619, p=0.005), circumferential resection margin between 0.1 mm and 10 mm (HR, 1.529, p=0.039), and more than one TD (HR, 2.688, p=0.001) were unfavorable prognostic factors for CSS. This population-based study identified predictors of OS and CSS in patients with early-stage resected rectal adenocarcinoma, which may help to guide future management of this patient population.

Do Older Patients With Moderate-Severe Chronic Graft-Versus-Host Disease Differ From Younger Patients?

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 725-725
Author(s):  
Areej El-Jawahri ◽  
Joseph Pidala ◽  
Xiaoyu Chai ◽  
William A. Wood ◽  
Nandita Khera ◽  
...  
Keyword(s):  
Overall Survival ◽  
Functional Status ◽  
Physical Functioning ◽  
Older Patients ◽  
Chronic Gvhd ◽  
Symptom Burden ◽  
Middle Aged ◽  
Aged Patients ◽  
Younger Patients ◽  
Sf 36

Abstract Introduction Older patients undergoing allogeneic stem cell transplantation may experience a higher degree of morbidity and limitations from transplant related complications. Chronic graft-versus –host disease (GVHD) causes a significant reduction in patients’ quality of life (QOL), physical functioning, and functional status. However, it is not known if moderate to severe chronic GVHD has a worse impact on QOL, or survival outcomes for older patients. Methods We analyzed data of patients with moderate or severe chronic GVHD (N=522, 1661 follow-up visits, a total of 2,183 visits) from the Chronic GVHD Consortium, a prospective observational multicenter cohort. Moderate or severe chronic GVHD was defined by the National Institutes of Health global severity score at the time of enrollment. We examined the relationship between age group (adolescent and young adult “AYA” 18-40, “middle-aged” 41-59, and “older” ≥ 60 years) and clinical manifestations of chronic GVHD, patient-reported outcomes, functional status, non-relapse mortality and overall survival. Clinical manifestations of chronic GVHD were determined by the clinician-reported individual organ scores. Patient-reported outcomes included (1) QOL as measured by Functional Assessment of Cancer Therapy Bone Marrow Transplantation (FACT-BMT) and the Medical Outcome Short-Form Health Survey (SF-36) (2) chronic GVHD symptom burden as measured by the Lee Symptom Scale; and (3) physical fitness as measured by the Human Activity Profile (HAP). Functional status was assessed using the 2-minute walk test (2MWT). Because of multiple testing, p-values <0.01 were considered significant. Results There were 115 (22%) AYA, 279 (53%) middle-aged and 128 (25%) older patients with moderate (58%) or severe (42%) chronic GVHD included. At study enrollment, older patients (≥60) were similar to younger patients in sex, time from transplant (median 12 months), prior acute GVHD, percentage of severe chronic GVHD, and current co-morbidity scores but differed in disease distribution and conditioning regimen intensity. At enrollment, in unadjusted analyses using all available data, older patients had similar rates and severity of global and organ-specific manifestations of chronic GVHD compared to younger patients, except for genital involvement, which was more prevalent and severe in AYA patients. Although older patients reported worse physical functioning [SF-36 Physical Functioning (p=0.01)], shorter 2MWT (p=0.002), and lower HAP scores (p=0.001) than AYA and middle-aged patients suggesting they have more physical limitations, older patients had better QOL [FACT-BMT (p=0.01)] scores compared to middle-aged patients and similar to AYA patients. Older patients had better psychological [Lee Psychological Scale (p<0.001), SF-36 Mental Health (p=0.01)] and emotional functioning [FACT-Emotional Well-being (p=0.001)] and less pain [SF-36 Bodily Pain (p=0.006)] than AYA and middle-aged patients but similar chronic GVHD symptom burden [Lee Symptom Scale (p=0.47)]. In multivariable linear mixed models utilizing all visit data and adjusted for clinical covariates, older patients had QOL (FACT-BMT) that was comparable to AYA patients (estimate -0.04, p=0.99) and better than middle-aged patients (estimate 5.7, p=0.004), while the SF36 physical and mental component scores and symptom burden were not different between the groups. Non-relapse mortality and overall survival were similar between the age groups in unadjusted analyses (p=0.23, p=0.17) and after adjusting for clinical covariates (p=0.17, p=0.15) in Cox models. In a subgroup analysis, we found that there were no differences in overall and organ-specific chronic GVHD manifestations, QOL and survival between patients in the 60-64 (n=73), 65-70 (n=39), and >70 (n=16) age groups, except for more moderate-severe skin involvement in the 65-70 year olds. Conclusion Despite higher physical and functional limitations, older patients with moderate or severe chronic GVHD have preserved QOL, comparable disease manifestations and symptom burden, and similar overall survival and non-relapse mortality when compared to younger patients. Therefore we did not find evidence that older age itself is associated with worse QOL or survival in patients with moderate or severe chronic GVHD. Disclosures: No relevant conflicts of interest to declare.

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.

Women and COVID-19: severity and mortality in hospitalized middle-aged and older patients

Climacteric ◽  
2021 ◽  
pp. 1-6
Author(s):  
L. Balcázar-Hernández ◽  
C. Martínez-Murillo ◽  
C. Ramos-Peñafiel ◽  
K. Pellón Tellez ◽  
B. Li ◽  
...  
Keyword(s):  
Older Patients ◽  
Middle Aged

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.

Functional Adaptation Skills Training (FAST): A randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders

2006 ◽  
Vol 86 (1-3) ◽  
pp. 291-299 ◽  
Author(s):  
Thomas L. Patterson ◽  
Brent T. Mausbach ◽  
Christine McKibbin ◽  
Sherry Goldman ◽  
Jesus Bucardo ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Psychosocial Intervention ◽  
Older Patients ◽  
Psychotic Disorders ◽  
Skills Training ◽  
Functional Adaptation ◽  
Middle Aged
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