scholarly journals Early-Onset Colorectal Adenocarcinoma in the IDEA Database: Treatment Adherence, Toxicities, and Outcomes With 3 and 6 Months of Adjuvant Fluoropyrimidine and Oxaliplatin

2021 ◽  
Author(s):  
Elisa Fontana ◽  
Jeff Meyers ◽  
Alberto Sobrero ◽  
Timothy Iveson ◽  
Anthony F. Shields ◽  
...  
Keyword(s):  
High Risk ◽  
Mortality Rate ◽  
Adverse Events ◽  
Treatment Adherence ◽  
Early Onset ◽  
Stage Iii ◽  
P Value ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Free Rate

PURPOSE Early-onset (EO) colorectal cancer (CRC, age < 50 years) incidence is increasing. Decisions on optimal adjuvant therapy should consider treatment adherence, adverse events, and expected outcomes in a population with life expectancy longer than later-onset (LO) CRC (age ≥ 50 years). MATERIALS AND METHODS Individual patient data from six trials in the International Duration Evaluation of Adjuvant Chemotherapy database were analyzed. Characteristics, treatment adherence, and adverse events in stage II or III EO-CRC and LO-CRC were compared. To reduce confounders of non–cancer-related deaths because of age or comorbidities, time to recurrence (3-year relapse-free rate) and cancer-specific survival (5-year cancer-specific mortality rate) were considered. RESULTS Out of 16,349 patients, 1,564 (9.6%) had EO-CRC. Compared with LO-CRC, EO-CRC had better performance status (86% v 80%, P < .01), similar T stage (% T1-3/T4: 76/24 v 77/23, P = .97), higher N2 disease rate (24% v 22%, P < .01), more likely to complete the planned treatment duration (83.2% v 78.2%, P < .01), and received a higher treatment dose intensity, especially with 6-month regimens. Gastrointestinal toxicity was more common in EO-CRC; hematologic toxicity was more frequent in LO-CRC. Compared with LO-CRC, significantly worse cancer-specific outcomes were demonstrated especially in high-risk stage III EO-CRC: lower 3-year relapse-free rate (54% v 65%; hazard ratio [HR] 1.33; 95% CI, 1.14 to 1.55; P value < .001) and higher 5-year cancer-specific mortality rate (24% v 20%; HR 1.21; 95% CI, 1.00 to 1.47; P value < .06). In this subgroup, no difference was observed with 3 or 6 months of therapy, with equally poor disease-free survival rates (57% v 56%; HR 0.97; 95% CI, 0.73 to 1.29; P value = .85). CONCLUSION Young age is negatively prognostic in high-risk stage III CRC and associated with significantly higher relapse rate; this is despite better treatment adherence and higher administered treatment intensity, suggesting more aggressive disease biology.

scholarly journals Modified STOP-Bang for predicting perioperative adverse events in the Thai population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa Sangkum ◽  
Chama Wathanavaha ◽  
Visasiri Tantrakul ◽  
Munthana Pothong ◽  
Cherdkiat Karnjanarachata
Keyword(s):  
High Risk ◽  
Adverse Events ◽  
Oxygen Therapy ◽  
Elective Surgery ◽  
Low Risk ◽  
Perioperative Outcomes ◽  
P Value ◽  
Icu Admission ◽  
Obstructive Sleep ◽  
Postanesthetic Care Unit

Abstract Background Undiagnosed obstructive sleep apnea (OSA) is associated with adverse perioperative outcomes. The STOP-Bang questionnaire is a validated screening tool for OSA. However, its precision may vary among different populations. This study determined the association between high-risk OSA based on the modified STOP-Bang questionnaire and perioperative adverse events. Methods This cross-sectional study included patients undergoing elective surgery from December 2018 to February 2019. The modified STOP-Bang questionnaire includes a history of Snoring, daytime Tiredness, Observed apnea, high blood Pressure, Body mass index > 30 kg/m2, Age > 50, Neck circumference > 40 cm, and male Gender. High risk for OSA was considered as a score ≥ 3. Results Overall, 400 patients were included, and 18.3% of patients experienced perioperative adverse events. On the basis of modified STOP-Bang, the incidence of perioperative adverse events was 23.2 and 13.8% in patients with high risk and low risk (P-value 0.016) (Original STOP-Bang: high risk 22.5% vs. low risk 14.7%, P-value 0.043). Neither modified nor original STOP-Bang was associated with perioperative adverse events (adjusted OR 1.91 (95% CI 0.99–3.66), P-value 0.055) vs. 1.69 (95%CI, 0.89–3.21), P-value 0.106). Modified STOP-Bang ≥3 could predict the incidence of difficult ventilation, laryngoscopic view ≥3, need for oxygen therapy during discharge from postanesthetic care unit and ICU admission. Conclusions Neither modified nor original STOP-Bang was significantly associated with perioperative adverse events. However, a modified STOP-Bang ≥3 can help identify patients at risk of difficult airway, need for oxygen therapy, and ICU admission. Trial registrations This study was registered on Thai Clinical Trials Registry, identifier TCTR20181129001, registered 23 November 2018 (Prospectively registered).

Early‐onset prostate cancer is associated with increased risks of disease progression and cancer‐specific mortality

The Prostate ◽  
2020 ◽  
Vol 81 (2) ◽  
pp. 118-126
Author(s):  
Hung‐Jen Shih ◽  
Su‐Chen Fang ◽  
Lu An ◽  
Yu‐Hsuan J. Shao
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Early Onset ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Impact of percent positive biopsy cores on cancer-specific mortality for patients with high-risk prostate cancer

2020 ◽  
Vol 38 (9) ◽  
pp. 735.e9-735.e15
Author(s):  
David D. Yang ◽  
Vinayak Muralidhar ◽  
Brandon A. Mahal ◽  
Marie E. Vastola ◽  
Ninjin Boldbaatar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
High Risk Prostate Cancer ◽  
Positive Biopsy ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

scholarly journals Subclassification of high-risk clinically organ-confined prostate cancer for early cancer-specific mortality after radical prostatectomy

2016 ◽  
Vol 46 (8) ◽  
pp. 762-767 ◽  
Author(s):  
Takashi Kobayashi ◽  
Takahiro Kimura ◽  
Chunwoo Lee ◽  
Takahiro Inoue ◽  
Naoki Terada ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Early Cancer ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Long-term cancer survival in cohorts of U.S. health professionals.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12075-12075
Author(s):  
En Cheng ◽  
Donghoon Lee ◽  
Rulla M Tamimi ◽  
Susan Hankinson ◽  
Walter C Willett ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cancer Patients ◽  
Health Professionals ◽  
Mortality Rates ◽  
Uterine Corpus ◽  
Specific Mortality ◽  
Colon And Rectum ◽  
Cancer Specific Mortality ◽  
Index Cancer

12075 Background: Few studies have investigated long-term survival and causes of death among men and women diagnosed with major cancers. Methods: We estimated overall and cause-specific mortality rates for men diagnosed with prostate, lung and bronchus, colon and rectum, bladder, and melanoma cancer in the Health Professionals Follow-up Study between 1986-2010+, and women with breast, lung and bronchus, colon and rectum, uterine corpus, thyroid, and ovarian cancer in the Nurses’ Health Study (NHS) between 1976-2010+ and NHS II between 1989-2010+. Kaplan-Meier curves were used to calculate cumulative mortality rates at 5, 10, 15, 20, and 30 years and competing risk methods were used to calculate cumulative cancer-specific mortality rates of major causes at 5, 10, 15, 20, and 30 years. Additionally, among women 40-year mortality rates were calculated. Results: Except for lung and ovarian, most major cancer patients are more likely to die from other causes than the index cancer. We observed two basic patterns for cumulative cancer-specific mortality rates. The first pattern is greatly diminished risk of index cancer-specific mortality 10 years or more following diagnosis - for colorectal cancer, cancer-specific mortality rate increased by less than 3% between 10 to 30- or 40-year following diagnosis (among men, from 35.1% to 36.7%; among women, from 34.8% to 37.7%), and this pattern also applied to bladder, melanoma, or uterine corpus cancer. The second one is sustained, but nevertheless low, excess risk - prostate cancer-specific mortality rate increased gradually and almost linearly from 5.3% to 15.1% after diagnosis from 5 to 30 years, and for breast cancer, it increased likewise from 7.2% to 18.9% after diagnosis from 5 to 40 years. Conclusions: Except for lung and ovarian cancers, patients diagnosed with major cancers were more likely to die from causes other than cancer. Colorectal, bladder, melanoma or uterine corpus cancer patients surviving more than 10 years after diagnosis are unlikely to ever die from that disease. [Table: see text]

scholarly journals Prostate cancer-specific mortality and the extent of therapy in healthy elderly men with high-risk prostate cancer

Cancer ◽  
2010 ◽  
Vol 116 (11) ◽  
pp. 2590-2595 ◽  
Author(s):  
Karen E. Hoffman ◽  
Ming-Hui Chen ◽  
Brian J. Moran ◽  
Michelle H. Braccioforte ◽  
Daniel Dosoretz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Elderly Men ◽  
High Risk Prostate Cancer ◽  
Healthy Elderly ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality
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