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Abstract Objective: This study aimed to investigate the demographic and clinicopathological characteristics, and survival outcomes of subglottic Squamous Cell Carcinoma (SCC) based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods: Demographic and clinicopathological information, including age, sex, race, tumor size, histologic grade, clinical/TNM stage, tumor invasion extent, Lymph Node Metastasis (LNM) extent, size of metastatic lymph nodes, LNM ratio and treatment data, of 842 subglottic SCC patients diagnosed between 1996 and 2016 were acquired. Kaplan-Meier survival analyses were performed to assess the effects of clinicopathological characteristics, treatment modalities, surgical procedures, and adjuvant therapies on overall survival and cancer-specific survival. Results: Subglottic SCC was more frequent among males aged 60-70 years, with low-grade but locally advanced lesions without local or distant metastases. Age and several primary tumor/LNM related variables were independent risk factors for overall survival and cancer specific survival. Advanced-stage and high-grade disease led to unfavorable prognosis. The most common treatment modality and surgical procedure were surgery plus radiotherapy and total laryngectomy, respectively. Surgery plus radiotherapy provided favorable 5-year survival outcomes, while total laryngectomy had the worst. Surgery plus adjuvant therapy showed better survival outcomes than surgery alone. Conclusion: This study confirmed the rarity of subglottic SCC. Patients with subglottic SCCs suffered poor prognosis especially for those with advanced-stage or high-grade lesions. The prognosis of subglottic SCC remained poor over the years, despite recent progress in cancer therapies. Surgery plus adjuvant therapy improved the survival outcome. Although larynx preservation surgery was beneficial for early-stage disease, total laryngectomy was favored for patients with advanced tumors. Level of evidence: Level 4.
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@#Objective To analyze the factors affecting the prognosis of patients with primary tracheal malignancy, and establish a nomogram model for prediction its prognosis. Methods A total of 557 patients diagnosed with primary tracheal malignancy from 1975 to 2016 in the Surveillance, Epidemiology, and End Results Data were collected. The factors affecting the overall survival rate of primary tracheal malignancy were screened and modeled by univariate and multivariate Cox regression analysis. The nomogram prediction model was performed by R 3.6.2 software. Using the C-index, calibration curves and receiver operating characteristic (ROC) curve to evaluate the consistency and predictive ability of the nomogram prediction model. Results The median survival time of 557 patients with primary tracheal malignancy was 21 months, and overall survival rates of the 1-year, 3-year and 5-year were 59.1%±2.1%, 42.5%±2.1%, and 35.4%±2.2%. Univariate and multivariate Cox regression analysis showed that age, histology, surgery, radiotherapy, tumor size, tumor extension and the range of lymph node involvement were independent risk factors affecting the prognosis of patients with primary tracheal malignancy (P<0.05). Based on the above 7 risk factors to establish the nomogram prediction model, the C-index was 0.775 (95%CI 0.751-0.799). The calibration curve showed that the prediction model established in this study had a good agreement with the actual survival rate of the 1 year, 3 year and 5 years. The area under curve of 1-year, 3-year and 5-year predicting overall survival rates was 0.837, 0.827 and 0.836, which showed that the model had a high predictive power. Conclusion The nomogram prediction model established in this study has a good predictive ability, high discrimination and accuracy, and high clinical value. It is useful for the screening of high-risk groups and the formulation of personalized diagnosis and treatment plans, and can be used as an evaluation tool for prognostic monitoring of patients with primary tracheal malignancy.
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Objective To study the component ratios of pancreatic carcinoma,and prognosis of patients with the different pathological types.Methods The data of 92 011 pancreatic carcinoma patients who were diagnosed by the definite pathological method from 2004 to 2014 were extracted from the US SEER database.The life table was used to calculate the 1-,3-and 5-year survival rates.The Kaplan-Meier was used to construct the survival curves of the patients.The Cox univariate analysis was applied to evaluate the HR of the different pathological types,and the x2 test and independent sample t-test were used to evaluate the base line data.Results The overall 5-year survival of 92 011 pancreatic carcinoma patients was 7.6％.The median survival time was 8.8 months and the component ratios of the pancreatic ductal adenocarcinoma (PDAC),pancreatic epithelium cancer bedside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 85.78％,6.40％,6.67％,0.97％,0.10％ and 0.08％,respectively.The differences were statistically significant between the baseline data such as age,gender,race and position (P ＜ 0.05).The overall 5-year survivals of the PDAC,pancreaticepithelium cancer beside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 4.2％,13.4％,49.2％,5.0％,29.2％ and 24.5％,respectively,and the median survival times were 5 months,7 months,58 months,2 months,26 months and 7 months respectively.The distant metastasis rate of neuroendocrine carcinoma was the lowest (35.0％).The undifferentiated carcinoma was the most prone to distant metastases (65.2％).Basically,half of the other types of pancreatic cancer had metastasis at the time of diagnosis.In pancreatic epithelium cancer beside the PDAC,the high to low 5-year survival rates were solid pseudopapillary carcinoma (87.3％),cystadenocarcinoma (36.8％),intraductal papillary mucinous neoplasm (36.5％),acinar cell carcinoma (20.0％),and pancreatic adenocarcinoma mixed with other subtypes (19.7％).The incidence of the other types of pancreatic carcinoma was less than 8％,such as mucinous carcinoma,squamous cell carcinoma,adenosquamous carcinoma and signet ring cell carcinoma.In neuroendocrine tumor,the 5-year survival rate of insulinoma (77.1％) was higher than those of neuroendocrine tumor (malignant) (NET,62.0％) and neuroendocrine carcinoma (NEC,46.5％).Conclusion The prognosis of pancreatic carcinoma was poor,and the pathological types had a significant impact on the prognosis of the patients.