scholarly journals Factors Affecting Survival in Patients with Breast Cancer in Hamedan Province from 2001 to 2018

2019 ◽  
Vol 12 (4) ◽  
pp. 31-38
Author(s):  
Rasoul Najafi ◽  
Fatemeh Amiri ◽  
Ghodrat Roshanaei ◽  
Mohammad Abbasi ◽  
Mahdi Razi
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Cancer Progression ◽  
Tumor Size ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Factors Affecting

Introduction: Breast cancer is the most common cancer and one of the leading causes of death in women. Identification of factors affecting the survival rate of these patients is important for the prevention of breast cancer progression and better treatment. Methods: This retrospective cohort study was performed on 493 women with breast cancer referred to Imam Khomeini clinic in Hamadan between 2001 and 2018. The Kaplan-Meier method and the Cox proportional hazard model were used to estimate the survival rate and factors affecting patient survival. All analyses were performed using SPSS 21. Results: The mean (standard deviation) age of the patients was 49.75 (11.34) years, and the 5- and 10-year survival rates were 61% and86%, respectively. The Cox proportional hazards model showed a significant relationship between age(HR (%95 CI)=1.53(1.23-2.78)) and tumor size (HR (%95 CI)=1.49(1.16-2.89)) and mortality risk (P < 0.05). Conclusion: Age and tumor size are associated with survival in patients with breast cancer. Therefore, increasing women’s awareness of the benefits of periodic examinations and early diagnosis can contribute to early detection of the disease and improved survival.

scholarly journals Questioning the sex-specific differences in the association of smoking on the survival rate of hospitalized COVID-19 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255692
Author(s):  
Athar Khalil ◽  
Radhika Dhingra ◽  
Jida Al-Mulki ◽  
Mahmoud Hassoun ◽  
Neil Alexis
Keyword(s):  
Survival Rate ◽  
Smoking Prevalence ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Smoking Status ◽  
Survival Rates ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Current Cigarette Smoking ◽  
High Smoking Prevalence

Introduction In the absence of a universally accepted association between smoking and COVID-19 health outcomes, we investigated this relationship in a representative cohort from one of the world’s highest tobacco consuming regions. This is the first report from the Middle East and North Africa that tackles specifically the association of smoking and COVID-19 mortality while demonstrating a novel sex-discrepancy in the survival rates among patients. Methods Clinical data for 743 hospitalized COVID-19 patients was retrospectively collected from the leading centre for COVID-19 testing and treatment in Lebanon. Logistic regression, Kaplan-Meier survival curves and Cox proportional hazards model adjusted for age and stratified by sex were used to assess the association between the current cigarette smoking status of patients and COVID-19 outcomes. Results In addition to the high smoking prevalence among our hospitalized COVID-19 patients (42.3%), enrolled smokers tended to have higher reported ICU admissions (28.3% vs 16.6%, p<0.001), longer length of stay in the hospital (12.0 ± 7.8 vs 10.8 days, p<0.001) and higher death incidences as compared to non-smokers (60.5% vs 39.5%, p<0.001). Smokers had an elevated odds ratio for death (OR = 2.3, p<0.001) and for ICU admission (OR = 2.0, p<0.001) which remained significant in a multivariate regression model. Once adjusted for age and stratified by sex, our data revealed that current smoking status reduces survival rate in male patients ([HR] = 1.9 [95% (CI), 1.029–3.616]; p = 0.041) but it does not affect survival outcomes among hospitalized female patients([HR] = 0.79 [95% CI = 0.374–1.689]; p = 0.551). Conclusion A high smoking prevalence was detected in our hospitalized COVID-19 cohort combined with worse prognosis and higher mortality rate in smoking patients. Our study was the first to highlight potential sex-specific consequences for smoking on COVID-19 outcomes that might further explain the higher vulnerability to death from this disease among men.

scholarly journals Milk Consumption Decreases Risk for Breast Cancer in Korean Women under 50 Years of Age: Results from the Health Examinees Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 32 ◽  
Author(s):  
Woo-Kyoung Shin ◽  
Hwi-Won Lee ◽  
Aesun Shin ◽  
Jong-koo Lee ◽  
Daehee Kang
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Epidemiologic Studies ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Milk Consumption ◽  
Korean Women

Epidemiologic studies regarding breast cancer risk related to milk consumption remain controversial. The aim of this study was to evaluate the association between milk consumption and the risk for breast cancer. A total of 93,306 participants, aged 40–69 years, were included in the prospective cohort study in the Health Examinees-Gem (HEXA-G) study between 2004 and 2013. Dietary intake was assessed using a validated food frequency questionnaire. Information on cancer diagnosis in the eligible cohort was retrieved from the Korea Central Cancer Registry through 31 December 2014. The Cox proportional hazards model was used to estimate multivariate hazard ratios (HRs) and 95% confidence intervals (CIs). A total of 359 breast cancer cases were observed over a median follow-up period of 6.3 years. Milk consumption was not associated with decreased risk for breast cancer in the total population (p for trend = 0.0687). In women under 50 years of age, however, milk consumption was inversely associated with breast cancer risk. In the comparison between highest (≥1 serving/day) and lowest (<1 serving/week) intake categories of milk, the multivariate HR (95% CI) was 0.58 (0.35–0.97, p for trend = 0.0195)) among women under 50 years of age. In conclusion, our findings show that milk consumption in Korean women aged 50 or younger is associated with a decreased risk for breast cancer, when compared to those who never or rarely consumed milk. Further studies need to be conducted to assess this relationship and confirm these results.

scholarly journals Comorbidities and Outcome of Alcoholic and Non-Alcoholic Liver Cirrhosis in Taiwan: A Population-Based Study

2020 ◽  
Vol 17 (8) ◽  
pp. 2825
Author(s):  
Tzu-Wei Yang ◽  
Chi-Chih Wang ◽  
Ming-Chang Tsai ◽  
Yao-Tung Wang ◽  
Ming-Hseng Tseng ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Survival Rates ◽  
Study Groups ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Study Cohort ◽  
Hazards Model

The prognosis of different etiologies of liver cirrhosis (LC) is not well understood. Previous studies performed on alcoholic LC-dominated cohorts have demonstrated a few conflicting results. We aimed to compare the outcome and the effect of comorbidities on survival between alcoholic and non-alcoholic LC in a viral hepatitis-dominated LC cohort. We identified newly diagnosed alcoholic and non-alcoholic LC patients, aged ≥40 years old, between 2006 and 2011, by using the Longitudinal Health Insurance Database. The hazard ratios (HRs) were calculated using the Cox proportional hazards model and the Kaplan–Meier method. A total of 472 alcoholic LC and 4313 non-alcoholic LC patients were identified in our study cohort. We found that alcoholic LC patients were predominantly male (94.7% of alcoholic LC and 62.6% of non-alcoholic LC patients were male) and younger (78.8% of alcoholic LC and 37.4% of non-alcoholic LC patients were less than 60 years old) compared with non-alcoholic LC patients. Non-alcoholic LC patients had a higher rate of concomitant comorbidities than alcoholic LC patients (79.6% vs. 68.6%, p < 0.001). LC patients with chronic kidney disease demonstrated the highest adjusted HRs of 2.762 in alcoholic LC and 1.751 in non-alcoholic LC (all p < 0.001). In contrast, LC patients with hypertension and hyperlipidemia had a decreased risk of mortality. The six-year survival rates showed no difference between both study groups (p = 0.312). In conclusion, alcoholic LC patients were younger and had lower rates of concomitant comorbidities compared with non-alcoholic LC patients. However, all-cause mortality was not different between alcoholic and non-alcoholic LC patients.

Relationship between taxane-induced neuropathy and clinical outcomes after adjuvant chemotherapy.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 270-270 ◽  
Author(s):  
B. P. Schneider ◽  
M. Wang ◽  
V. Stearns ◽  
S. Martino ◽  
V. E. Jones ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Time Dependent ◽  
Individual Treatment ◽  
Axillary Lymph ◽  
Landmark Analysis

270 Background: Neuropathy is a common and potentially enduring and disabling complication of adjuvant taxane therapy. Recent studies have identified candidate host single nucleotide polymorphisms (SNPs) associated with taxane-induced neuropathy (Schneider et al. ASCO 2011, abstr. 1000). We therefore sought to determine whether neuropathy was associated with breast cancer recurrence. Methods: This study included 4,950 eligible women with axillary lymph node positive or high-risk node-negative breast cancer who received up to 4 cycles of AC (doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2) every 3 weeks, followed by either: (1) paclitaxel 175 mg/m2 every 3 weeks x 4 (P3), (2) paclitaxel 80 mg/m2 weekly x 12 (P1), (3) docetaxel 100 mg/m2 every 3 weeks x 4 (D3), or (4) docetaxel 35 mg/m2 weekly x 12 (D1). Chemotherapy doses were based on actual body weight. Cox proportional hazards model were used to determine the relationship between neuropathy and disease free survival (DFS) and overall survival (OS) treating neuropathy status as a time dependent covariate and using a landmark analysis. Results: Of 4,702 patients who received at least 1 taxane dose, grade 2-4 neuropathy developed in 20%, 27%, 16%, and 16% in the P3, P1, D3, and D1 arms, respectively. In a model including age, tumor size, nodal status, treatment arm, neuropathy, and the neuropathy- treatment interaction, there was no relationship between neuropathy and DFS and OS in the entire population, for any of the individual treatment arms, or for any breast cancer subtypes, whether analyzed as a time-dependent covariate or using a landmark analysis. Baseline covariates associated with an increase rate of neuropathy included black race (25% vs. 19% grade 2-4, p=0.02) and obesity (21% vs. 19%, p=0.04), but not age. Conclusions: There was no association between taxane-induced neuropathy and DFS or OS in patients treated with contemporary AC-taxane therapy, including weekly paclitaxel. These findings show that taxane-induced neuropathy is not associated with outcome, thus suggesting that validation of SNPs predictive of neuropathy may be useful in identifying patients at higher risk for neuropathy but not taxane benefit and thereby improve therapeutic individualization.

Disparities in receipt of radiotherapy and survival by age, sex, and race among patients with nonmetastatic squamous cell carcinoma of the anus.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 721-721
Author(s):  
Doug Baughman ◽  
Krishna Bilas Ghimire ◽  
Binay Kumar Shah
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Survival Rates ◽  
Relative Survival ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
P Value ◽  
Hazards Model ◽  
To Receive

721 Background: Combination chemoradiotherapy is the standard of care for treatment of non-metastatic squamous cell carcinoma of the anus (SCCA). This population-based study evaluated disparities in receipt of radiotherapy (RT) and its effect on survival in patients with localized and regional SCCA in the United States. Methods: The Surveillance, Epidemiology, and End Results (SEER) 18 database was used to identify patients with localized and regional SCCA diagnosed between 1998 and 2008. We used univariate and multivariate logistic regression to model the relationships between receipt of RT and age, sex, marital status, stage, and race. Relative survival rates were calculated and compared using two sample z-tests. A Cox proportional hazards model was used to find adjusted hazard ratios (HR). Results: A total of 3,971 patients with localized or regional SCCA as the only primary malignancy were included in the study, of which 3,278 (82.6%) received RT. After adjusting for covariates, those 65 years and older (adjusted OR 0.82, p=0.029) were less likely to receive RT. Females were more likely to receive RT compared to males (adjusted OR 1.54, p<0.001). We found no difference in receipt of RT by race. Comparisons of 1- and 5-year relative survival rates showed lower survival for blacks (p-value <0.01 at 1-year and <0.0001 at 5-years), those 65 years and older, and males. A 1-year survival disparity was found for those not receiving RT (p-value <0.0001 at 1-year), but no difference was observed at 5-years. A Cox proportional hazards model adjusting for all covariates showed greater hazard for blacks (adjusted HR 1.36, p=0.001), those not receiving RT (adjusted HR 1.23, p=0.03), patients 65 years or older, and males. Conclusions: This population based study identified older patients as less likely to receive RT and females as more likely to receive RT. Survival analysis identified blacks, males, older patients, and those not receiving RT as having lower rates of survival.

Differences in Male Breast Cancer Stage, Tumor Size at Diagnosis, and Survival Rate Between Metropolitan and Nonmetropolitan Regions

2011 ◽  
Vol 5 (5) ◽  
pp. 430-437 ◽  
Author(s):  
Judith Klein ◽  
Ming Ji ◽  
Nancy K. Rea ◽  
Georjean Stoodt
Keyword(s):  
Breast Cancer ◽  
Survival Rate ◽  
Male Breast Cancer ◽  
Tumor Size ◽  
Family Income ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Male Breast ◽  
Cancer Stage ◽  
Survival Differences

Although the incidence for breast cancer in men is lower than for women, male breast cancer (MBC) patients are diagnosed at a later stage and have a higher mortality rate than women. This study examined male cases reported from 1988 through 2006 in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute for differences in cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions. Pearson’s chi-square was used to evaluate differences in stage and tumor size at diagnosis. Cox proportional hazards regression was used to assess survival differences after adjusting for confounders (race, marital status, median family income, age, and education). Regional differences in tumor grade size and stage at diagnosis were not statistically significant; however, survival differences were observed between metropolitan and nonmetropolitan regions. An interaction between nonmetropolitan area and regional stage MBC was a significant predictor of poorer survival. Raising awareness of MBC in nonmetropolitan areas could save the lives of many men and action should be taken to improve health care access, treatment, and thus prognosis in this population.

Multiple chemotherapy (CT) lines in metastatic breast cancer (MBC): Which survival benefit for women with hormone receptor (HR)-positive disease?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 589-589 ◽  
Author(s):  
Raffaella Palumbo ◽  
Antonio Bernardo ◽  
Alberto Riccardi ◽  
Federico Sottotetti ◽  
Cristina Teragni ◽  
...  
Keyword(s):  
Survival Benefit ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Univariate Analysis ◽  
Metastatic Breast ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Factors Affecting ◽  
Significant Difference ◽  
Third Line

589 Background: Although the development of modern systemic therapies has clearly improved outcome of patients with MBC, the true impact of further CT on overall survival (OS) and QoL of these women is still debated. The aim of this study was to determine which benefit could be brought by successive CT lines in patients with HR-positive disease, aiming to identify factors affecting outcome and survival. Methods: This retrospective analysis included 980 women treated with CT for MBC at our Institution over a eight year period (July 2000-July 2008). With OS data updated in March 2010, the median follow-up was 146 months (range 48-198), OS and time to treatment failure (TTF) were calculated according to the Kaplan-Meyer method for each CT line. Cox proportional hazards model was used to identify factors that could influence TTF and OS. Results: Median OS evaluated from day 1 of each CT line decreased with the line number from 34.8 months for first line to 8.2 months for 7 or more lines). Median TTF ranged from 9.2 months to 7.8 and 6.4 months for the first, second and third line, respectively, with no significant decrease observed beyond the third line (median 5.2 months, range 4.8-6.2). No statistically significant difference was found between HR-positive and HR-negative patients in terms of OS and TTF by each CT line. In univariate analysis factors positively linked to a longer duration of TTF for each CT line were positive hormonal receptor status, more than 3 hormonotherapy lines, absence of liver metastasis, adjuvant CT exposure, response to CT for the metastatic disease; in the multivariate analysis the duration of TTF for each CT line was the only one factor with significant impact on survival benefit for subsequent treatments, in both HR-positive and negative populations (p<0.001). Conclusions: Our results support the benefit of multiple lines of CT in a significant subset of women treated for MBC, since each CT line may contribute to a longer OS. Of interest, such a benefit was also observed for patients with HR-positive disease, although the number of hormonotherpy lines received did not significantly influence the outcome.

Serum IGFBP4 levels in combination with miliary disease: A candidate predictor of ovarian cancer progression-free survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5079-5079
Author(s):  
Samantha Cohen
Keyword(s):  
Ovarian Cancer ◽  
Cancer Progression ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Residual Disease ◽  
Statistical Significance ◽  
Serum Levels ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Separate Analysis

5079 Background: Insulin-like growth factor binding protein, IGFBP4, was shown to be highly expressed across all stages of epithelial ovarian cancer (EOC) and serum levels are elevated in EOC. Moreover, IGFBP4 levels are ~3x greater in women with malignant pelvic masses. We investigated whether ascites volume and the presence of miliary disease in combination with serum levels of IGFBP4 are independent predictors of survival. Methods: A prospective and retrospective analysis was performed. Patients were enrolled at the time of cytoreductive surgery. Ascites volume was either absent, <500 cc (low), or >= 500 cc (high), and the presence of miliary disease was recorded. The IGFBP4 cutoff was 1064.5 ug/ml based upon previous results. The Kaplan-Meier product limit method was used to estimate PFS probabilities. The Cox proportional hazards model was used to estimate hazard ratios (HR) and corresponding 95% CI. Results: 57 cases were included in the analysis of ascites volume and miliary disease. Cytoreductive outcomes were complete gross resection (44.8%), optimal (<=1cm residual disease; 44.8%), and suboptimal ( >1cm residual disease; 10.3%). Histologic subtypes: papillary serous (n=35; 61.4%), mucinous (n=15; 26.3%), endometrioid (n=4; 7.0%), and clear cell (n=3; 5.3%). Stage distribution was 21.1% I/II, and 78.9% III/IV. PFS was unaffected by ascites volume (p=0.341) or miliary disease. Among this cohort, 29 had IGFBP4 levels available for a separate analysis. Patients with high IGFBP4 and miliary disease were 5.5 times as likely to recur compared with patients with miliary disease and low IGFBP4 (HR=5.55 [0.77, 39.82]), and the statistical significance was borderline (p<0.088). No statistically significant differences were detected between rates of recurrence among patients with high and low IGFBP4 values in combination with ascites volume. Conclusions: These exploratory studies suggest that patients with high IGFBP4 serum levels and miliary disease were > 5 times as likely to recur compared to women with miliary disease and low IGFBP4 levels. Future studies examining these variables using a larger population and examining the biologic basis of this relationship are planned.

Tumor sidedness, adjuvant chemotherapy (AC), and other factors affecting survival in patients with stage II colon cancer (CC-II).

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 768-768
Author(s):  
Shiva Kumar Reddy Mukkamalla ◽  
Donny V. Huynh ◽  
Ponnandai Sadasivan Somasundar ◽  
Ritesh Rathore
Keyword(s):  
Colon Cancer ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Tumor Grade ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Metastatic Colon Cancer ◽  
Chi Square ◽  
Factors Affecting ◽  
Academic Level

768 Background: The role of AC in CC-II is not well defined due to lack of conclusive randomized trial data. This updated analysis using National Cancer Database (NCDB) addresses the overall survival (OS) benefit from AC in CC-II using more refined and case appropriate population cohort. Methods: NCDB was queried for patients diagnosed with CC-II from 2004-2008 with survival information through 2013. Only those patients with pathologically confirmed CC diagnosis were included. Patients undergoing any surgical procedure less than a partial colectomy were excluded. Pearson Chi-square test, Kaplan Meier survival curves and Cox proportional hazards model were used for statistical analysis. Results: A cohort of 36,630 patients was identified for analysis. Elderly patients received less frequent AC (p < 0.0001) and AC was associated with an improved 5-year OS with no difference noted in outcomes from single or multi-agent regimens. AC was an independent predictor of OS regardless of age, gender, race, comorbidity index, insurance status, income level, year of diagnosis, tumor sidedness, tumor grade, adequacy of lymph node evaluation, pathologic tumor (pT) status, colectomy type, margin involvement or academic level of treating institution. In multivariate analysis, right-sided cancers had better survival outcomes compared to left-sided cancers (HR 0.91; p < 0.0001). Conclusions: This study validates previous findings of improved OS from AC in CC-II while addressing some of the shortcomings of prior retrospective studies. Only patients with CC-II without any other primary cancer diagnoses were included. To our knowledge this is the most uptodate analysis of AC in CC-II which includes cases diagnosed up to 2008. Our study found similar improvement in 5-year OS irrespective of chemotherapy regimen. Interestingly, improved OS was seen in right sided tumors compared to left sided tumors, in contrary to that seen with metastatic colon cancer (Venook et al). [Table: see text]

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