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1.
Article in Chinese | WPRIM | ID: wpr-910445

ABSTRACT

Objective:Ameloblastoma (AM) is a rare tumor derived from dental epithelial tissues, which is prone to recurrence and infiltration. This study aims to identify the prognostic factors of AM.Methods:207 ameloblastoma patients were screened from the SEER database. A Cox regression model and nomogram were constructed to evaluate the factors on the overall survival. Clinical data of 61 patients admitted to Hunan Cancer Hospital were retrospectively analyzed. The independent factors of recurrence rate were analyzed by the Cox regression model.Results:The results on the SEER database showed that age, tumor size, type of surgery, radiotherapy were important prognostic factors of the overall survival. The nomogram was constructed and the C-index was equaled to 0.821, indicating this model was moderately accurate. The receiver operating characteristic (ROC) curve demonstrated that the area under the ROC curve (AUC) at 1, 3, 5, and 10 years were 0.852, 0.869, 0.856, and 0.879, indicating this model had relatively high sensitivity and specificity. Kaplan- Meier survival analysis suggested that overall survival in the high-risk group was significantly lower than that in the low-risk group ( P<0.001). Based on retrospective analysis, clinical symptoms and type of surgery were the independent factors of the local recurrence rate. Kaplan- Meier survival analysis found the recurrence rate of facial swelling and pain was lower compared to those of other symptoms. Compared with the palliative surgery, radical surgery could decrease the recurrence rate. Conclusions:Age, tumor size, type of surgery, and radiotherapy may be important factors of the overall survival. Type of surgery and clinical symptoms are probably the independent factors of the recurrence rate.

2.
Article in Chinese | WPRIM | ID: wpr-910374

ABSTRACT

Objective:To explore the impacts of postoperative radiotherapy on long-term survival of the patients with resectable locally advanced (T 3-4and/or N +) biliary tract cancers (BTCs) and to analyze the prognostic factors. Methods:The patients with locally advanced gallbladder cancer ( n=1 922) and the patients with extrahepatic biliary duct cancer ( n=3 408) who received surgical resection during 2006-2016 were selected from the Surveillance, Epidemiology, and End Result (SEER) database. They were grouped according to different treatment schemes (only surgery and surgery + radiation). The propensity score matching (PSM) method was employed to adjust the differences in baseline prognostic characteristics between patients who received only surgery and those treated with surgery+ radiation. The role of the two treatment schemes on the survival of the patients was analyzed using the Kaplan-Meier method and the prognosis factors were assessed using the Cox regression. Results:The 1 174 patients with gallbladder cancers and the 2 144 patients with extrahepatic biliary duct cancer were respectively matched according to propensity scores. The postoperative radiotherapy showed a significant advantage in 5-year cancer-specific survival (CSS) compared to only surgery for both the patients with gallbladder cancer ( χ2=35.73, P< 0.001) and those with extrahepatic biliary duct cancer ( χ2=9.878, P=0.002). After adjusting related covariates, independent prognostic factors for all the patients included pathological grading, T status, N status, treatment pattern, and age. For the patients with extrahepatic biliary duct cancer, independent prognostic factors also included race and year of diagnosis. The benefits of postoperative radiotherapy were observed in various clinicopathologic characteristics except for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of Ⅰ-Ⅱ and N 0 status or with age ≥ 70. Conclusions:Long-term survival benefits can be gained through postoperative radiotherapy for the patients with resectable locally advanced (T 3-4 and/or N+ ) BTCs. However, adjuvant radiation should be cautiously adopted for the patients with T 1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of I-Ⅱ and N 0 status or with age ≥70.

3.
International Journal of Surgery ; (12): 726-731,f3, 2021.
Article in Chinese | WPRIM | ID: wpr-907513

ABSTRACT

Objective:To investigate the important risk factors for the prognosis of patients with colorectal cancer (CRC) based on SEER database, and to construct a line chart prognostic model of 1-, 3-and 5-year survival rates for CRC patients.Methods:The clinical data of 52814 patients with CRC diagnosed pathologically from 2010 to 2015 in SEER database were collected. Cox proportional hazard model was used for univariate and multivariate survival analysis to determine the prognostic risk factors. Stepwise regression was used to screen the clinical factors that had the greatest impact on prognosis. Calibration curve was used to evaluate the accuracy of line chart prediction model for predicting 1-, 3-and 5-year OS in patients with CRC.Results:Surgical method, age, LNR, AJCC stage, T stage, N stage, M stage, vascular tumor thrombus and nerve invasion were independent risk factors for prognosis. Stepwise regression analysis showed that age, T stage, M stage, LNR and mode of operation were the most associated with the prognosis of CRC. A line chart model was constructed based on these five factors. The consistency index of age/T staging/M staging/LNR/ operation on the training set and verification set was the highest, which were 0.762 and 0.756 respectively. ROC curve analysis showed that in the training set and verification set, the AUC of age/T stage/M stage/LNR/ operation prognosis model was more than 0.7, and the model had high diagnostic value.Conclusion:The CRC prognostic line chart model based on age/T staging/M staging/LNR/ operation has a better predictive effect. The constructed prognosis OS diagram is convenient for clinical oncologists to make a more accurate assessment of the prognosis of patients, and provides a theoretical basis for individual diagnosis and treatment of CRC patients.

4.
Article in English | WPRIM | ID: wpr-888508

ABSTRACT

To develop a survival time prediction model for patients with ovarian serous cystadenocarcinoma after surgery. A retrospective analysis of 5906 postoperative patients with ovarian serous cystadenocarcinoma in the surveillance, epidemiology, and end results (SEER) database from 2010 to 2015 was performed. The independent risk factors for long-term survival were analyzed with multivariate Cox proportional hazard regression model. The nomogram of 3-year and 5-year survival was developed by using R language. The receiver operator characteristic (ROC) curve and were used to test the discrimination of the model and the calibration diagram was used to evaluate the degree of calibration of the prediction model. The survival curves was conducted by the risk factors. Cox proportional hazard regression model showed that age, race, histological grade (poorly differentiated and undifferentiated), stage T (T2a, T2b, T2c, T3a, T3b and T3c), and stage M (M1) were independent factors for the prognosis of patients with ovarian serous cystadenocarcinoma after surgery. A nomogram was developed by the R language tool for predicting the 3-year and survival of patients through age, race, histological classification, stage T and stage M. The C-index was 0.688 and the areas under ROC curve of the nomogram for predicting 3-year and 5-year survival were 0.708 and 0.716, respectively. The results of the calibration indicated that the predicted values were consistent with the actual values in the prediction models. The survival time of patients with high-risk factors was shorter than that of patients with low-risk factors (<0.05). The developed nomogram in this study can be used to predict 3-year and 5-year survival of postoperative patients with ovarian serous cystadenocarcinoma, and it may be beneficial to guide clinical treatment.


Subject(s)
Cystadenocarcinoma, Serous/surgery , Humans , Neoplasm Staging , Nomograms , Prognosis , ROC Curve , Retrospective Studies , SEER Program , Survival Rate
5.
Article in English | WPRIM | ID: wpr-888496

ABSTRACT

To investigate whether chemotherapy could prolong the postoperative survival time in patients with early stages pancreatic ductal adenocarcinoma (PDAC). A total of 5280 stage ⅠA -ⅡB PDAC patients diagnosed from 2010 to 2015 were selected from surveillance,epidemiology,and end results (SEER) database. Propensity score matching (PSM) analysis was adopted to reduce the baseline differences between the groups. Univariate survival analysis was conducted with the Kaplan-Meier method. Multivariate survival analysis was performed with the Cox proportional hazards model. Univariate and multivariate survival analyses showed that age, differentiation, stage, chemotherapy were independent risk factors for the survival of PDAC patients. After PSM, it is found that adjuvant chemotherapy could prolong the median overall survival time (mOS) for stage ⅠB, ⅡA and ⅡB patients. However, for stage ⅠA patients, there were no significant differences in 3-year survival rate and mOS between patients with chemotherapy (=283) and without chemotherapy (=229) (57.4% vs 55.6%, vs all >0.05). Further analyses show that among 101 patients with well differentiated PDAC and 294 patients with moderately differentiated PDAC, there were no significant differences in survival rate and mOS between patients with and without chemotherapy (all >0.05). Among 117 patients with low-differentiated + undifferentiated PDAC, 3-year survival rate and mOS in patients with chemotherapy were significantly better than those without chemotherapy (48.5% vs 34.1%, vs all <0.05). Chemotherapy regimen used currently is not beneficial for patients with moderately and well differentiated stage ⅠA PDAC, but it is an independent prognostic factor for low-differentiated + undifferentiated PDAC patients.


Subject(s)
Adenocarcinoma/pathology , Carcinoma, Pancreatic Ductal/surgery , Chemotherapy, Adjuvant , Humans , Neoplasm Staging , Pancreatic Neoplasms/drug therapy , Prognosis , Propensity Score
6.
Article in Chinese | WPRIM | ID: wpr-829935

ABSTRACT

Objective@# To explore the influence of marital status on the survival of patients with buccal mucosa squamous cell carcinoma (BMSCC) and to provide a scientific basis for risk assessment and nursing decisions for these patients.@*Methods @# A total of 1 006 BMSCC participants were identified in the Surveillance, Epidemiology, and End Results(SEER) database. Kaplan-Meier analysis was used to evaluate the effect of marital status (married, unmarried and unhappily married) on the survival of patients with buccal squamous cell carcinoma. The independent prognostic effect of marital status was further determined by univariate and multivariate Cox proportional hazard regression analysis.@*Results@# Marital status was an independent prognostic factor for BMSCC patients (P=0.001). Married patients had the best survival, while separated/divorced/widowed patients had the worst survival (HR=1. 445, P=0.001), and never married patients had an intermediate risk (HR=1.297, P=0.040).@*Conclusion@#Marital status was an independent prognostic factor for BMSCC patients. Unmarried and unhappily married patients had worse survival, which suggests that we should pay more attention to patients’ marital status, especially unmarried and unhappily married patients.

7.
Article in Chinese | WPRIM | ID: wpr-828879

ABSTRACT

OBJECTIVE@#To investigate the value of positive lymph node ratio (LNR) in predicting the prognosis of patients with esophageal cancer.@*METHODS@#We retrieved the data of a total of 862 patients with esophageal cancer with complete clinical pathology data archived in SEER database in 2010 to 2015. The best cutoff point of LNR was selected using X-tile software. Univariate and multivariate COX proportional hazard models were used to assess the value of LNR in predicting the prognosis of patients after propensity score matching (PSM).@*RESULTS@#The best cut-off point of LNR determined using X-tile 3.6.1 software was 0.16. The patients with LNR < 0.16 and those with LNR≥0.16 showed significant differences in the number of positive lymph nodes, pathological type, T stage and M stage. After 1:1 propensity score matching, the two groups showed no significant difference in the clinical data or pathological parameters. Matched univariate and multivariate COX regression analyses showed that LNR, primary tumor site and M staging were all independent risk factors affecting the prognosis of patients, and among them LNR had the most significant predictive value (LNR < 0.16 LNR≥0.16: HR=1.827, 95% : 1.140-2.929; =0.000). The median survival time of patients with LNR < 0.16 was 31 months (95%: 22.556-39.444 months), as compared with 16 months (95%: 12.989-19.011) in patient with LNR≥0.16 (Log Rank χ=27.392, < 0.0001). LNR had a better accuracy than N stage for assessing the patients' prognosis with an area under the ROC curve of 0.617 (95%: 0.567-0.666), as compared with 0.515 (95%: 0.463-0.565) of N stage (=3.008, =0.0026).@*CONCLUSIONS@#LNR≥0.16 is an independent risk factor affecting the prognosis of patients with esophageal cancer and has better prognostic value than N stage.


Subject(s)
Esophageal Neoplasms , Humans , Lymph Node Excision , Lymph Node Ratio , Lymph Nodes , Lymphatic Metastasis , Neoplasm Staging , Prognosis , Retrospective Studies , Risk Factors
8.
Article in English | WPRIM | ID: wpr-719331

ABSTRACT

PURPOSE: The purpose of this study was to investigate the non-inferiority of omitting radiotherapy (RT) after breast-conserving surgery (BCS) for hormone receptor (HR)‒positive T1N0 breast cancer in elderly women. MATERIALS AND METHODS: From 2004 to 2014, HR-positive T1N0 breast cancer patients aged 50 years or older and receiving BCS were retrieved from the Surveillance, Epidemiology, and End RESULTS: 18 database. After propensity score matching between the no-RT and RT groups, univariate and multivariate analyses were performed. Identified prognostic factors were used to stratify the risk groups. In each risk group, 10-year cancer-specific survival (CSS) rates were compared between the no-RT and RT groups. RESULTS: After propensity score matching, the numbers of patients in the no-RT and RT groups were both 18,586. For patients who satisfied both a tumor size of 1-10 mm and a tumor grade of 1-2, omitting RT did not decrease the CSS rate at any age group, ranging from ≥ 50 to ≥ 85 years; for patients aged ≥ 50 years, the 10-year CSS rates in the no-RT and RT groups were 97.2% and 96.8%, respectively (adjusted hazard ratio, 0.862; p=0.312). However, for patients with a tumor size of 11-20 mm or tumor grade of 3-4, RT significantly increased the CSS rate irrespective of age. CONCLUSION: RT after BCS for HR-positive T1N0 breast cancer in elderly women might be omitted without causing a decrease in the CSS rate, but only in patients who satisfy both a small tumor size (≤ 10 mm) and low tumor grade (1-2).


Subject(s)
Aged , Breast Neoplasms , Breast , Epidemiology , Female , Humans , Mastectomy, Segmental , Multivariate Analysis , Propensity Score , Radiotherapy , Radiotherapy, Adjuvant , Receptors, Estrogen , Receptors, Progesterone
9.
Article in Chinese | WPRIM | ID: wpr-861751

ABSTRACT

Background: The morbidity of small bowel adenocarcinoma (SBA) in gastrointestinal neoplasms is relatively low, and there are few studies focusing on the clinicopathological features and prognostic data of SBA both at home and abroad. Aims: To investigate the metastatic characteristics and prognosis of patients with SBA. Methods: Patients with SBA were identified from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2016. Data on metastatic patterns, clinicopathological features and prognosis were extracted and analyzed, and the prognostic factors were assessed by Cox proportional hazard model. Results: A total of 2 489 cases of SBA were identified, of which 448 cases (18.0%) had liver metastasis, 48 (1.9%) had bone metastasis, and 129 (5.2%) had lung metastasis. Different metastatic sites were associated with different clinicopathological parameters. There were no significant differences in bone or lung metastasis between patients with and without liver metastasis (P>0.05). The median overall survival (OS) of patients with liver, bone, and lung metastasis was 6, 4, and 8 months, respectively, all were shorter than that of patients without metastasis at corresponding site (P<0.05). Surgical resection of primary tumor improved the OS of patients without metastasis and with liver metastasis, but had no effect on OS of patients with lung or liver plus lung metastases. Multivariate analysis showed that aged more than 66 years, poorly differentiated and undifferentiated tumors, and lymph node metastasis were independent risk factors for poor prognosis, while married and surgical resection of primary tumor were protective factors. Conclusions: SBA patients with metastasis had a poorer OS than those without. Different metastatic characteristics are associated with different prognosis. Liver is an important distant metastatic organ for SBA. For SBA patients, married and surgical resection of primary tumor are beneficial factors, whereas advanced age, poorly differentiated, undifferentiated, and lymph node metastasis are predictors of poor prognosis.

10.
Article in Chinese | WPRIM | ID: wpr-816078

ABSTRACT

OBJECTIVE: To investigate the prognostic factors of esophageal cancer with brain metastasis. METHODS: SEER Stat 8.3.5 was used to collect 39 cases of esophageal cancer with brain metastasis from 2010 to 2015 in the Surveillance, Epidemiology and End RESULTS:(SEER) database. X-tile software was used to determine the best cut-off value of the age. Prognostic factors were analyzed with log-rank and Cox proportional hazard model by SPSS(v25.0). RESULTS: The median survival time of patients with esophageal cancer with brain metastasis was 7.0 months, the 6-month survival rate was 53.3%, and the 1-year survival rate was 16.3%. Only age(χ~2=4.045, P=0.044)was the prognostic factor, while there was insufficient evidence to show whether gender, marriage, race, primary site, histological grade,surgery, pathological type, T stage or N stage was associated with the prognosis of the patients. CONCLUSION: Brain metastasis is a rare metastatic type of esophageal cancer. Age is associated with worse prognosis, while the influences of other risk factors are not clear.Active treatment can lead to better prognosis.

11.
Article in Chinese | WPRIM | ID: wpr-816077

ABSTRACT

OBJECTIVE: To construct a model for predicting the prognosis of esophageal cancer bone metastasis. METHODS: The clinical data of 183 patients with esophageal cancer bone metastasis were analyzed retrospectively, and the prognostic factors of patients were analyzed by log-rank method and Cox proportional hazard model. Nomogram was constructed with the accelerated failure-time model.RESULTS: The average survival time(10.0 months, 95% CI:7.758-12.338) of patients aged 28-70 years was longer than that of patients aged 71-91(6.4 months, 95% CI:4.365-8.428)(χ~2=4.077, P=0.043). The prognosis of unmarried patients(average 7.0 months) was worse than that of the married(10.5 months on average)(χ~2=12.841, P<0.001). As for prognoses of different pathological types, the differences between adenocarcinoma(average 10.2 months, 95% CI:7.797-12.548), squamous cell carcinoma(average 6.4 months,95%CI:3.895-8.899) and other types(average 4.0 months, 95% CI:4.000-4.000) were statistically significant(χ~2=7.171, P=0.028).There were also significant differences between the prognoses of patients with different T stage(χ~2=8.833, P=0.032). Nomogram was constructed with the risk factors above and the C-index reached 0.675(95%CI: 0.626-0.725). CONCLUSION: The prognosis of esophageal cancer bone metastasis was poor. Marriage, T stage, histological grade and pathological types were risk factors affecting prognosis, while N stage didn't appear to show obvious effect on prognosis. The nomogram was tested to have a good predictive capacity.

12.
Article in Chinese | WPRIM | ID: wpr-816076

ABSTRACT

OBJECTIVE: To analyze the prognostic factors related to liver metastasis of esophageal cancer and establish an effective prediction model. METHODS: The data of 464 cases of esophageal cancer with liver metastasis from 2010 to 2015 was collected from the National Cancer Institute SEER database by SEER stat 8.3.5 software. SPSS(v25.0) was used to analyze the prognostic factors of esophageal cancer liver metastasis and Kaplan-Meier curve was used for survival analysis. We introduced the meaningful variables of single factor analysis in Cox proportional hazard model and multivariate analysis and obtained the independent influencing factors of prognosis.Independent factors were then included in the accelerated failure time model to construct the nomogram. RESULTS: The mean survival time of patients in this study was 11.6 months(95%CI: 10.075-13.209), and their 1-, 3-, and 5-year survival rates were 29.4%, 5.5%, and 0,respectively. Age(HR=1.452, 95% CI: 1.175-1.795), marriage(HR=0.753, 95%CI: 0.611-0.927) and surgery(HR=0.428, 95% CI: 0.227-0.807) were independent prognostic factors for patients. We constructed the nomogram with risk factors of prognosis, and the C-index value was 0.614. CONCLUSION: The prognosis of esophageal cancer liver metastasis is poor. being young, Being married, and surgery are associated with better survival, and the nomogram we have constructed is proved to have good predictive ability.

13.
Article in Chinese | WPRIM | ID: wpr-816075

ABSTRACT

OBJECTIVE: To establish a prediction model for the prognosis of patients with esophageal cancer lung metastasis.METHODS: Data from 194 patients with esophageal cancer lung metastasis from 2010 to 2015 was collected from the National Cancer Institute Surveillance, Epidemiology and End RESULTS:(SEER) database. The best cutoff value for age was determined by X-tile software.Prognostic factors were analyzed by SPSS(v25.0) with the log-rank method and the Cox proportional hazard model. Risk factors from univariate analysis were used to construct prediction nomogram with R studio software(version 3.5.1). RESULTS: The median survival time of 194 patients with esophageal cancer lung metastasis was 7.0 months, the 3-month survival rate was 69.9%, and the 1-year survival rate was 27.7%. Age(HR=1.51, 95% CI: 1.066-2.140) and pathological type(HR=0.736, 95% CI: 0.543-0.998) were independent prognostic factors for patients with esophageal cancer lung metastasis. The value of C-index was 0.634(95% CI=0.585-0.683). CONCLUSION: For patients with esophageal cancer lung metastasis, being young and adenocarcinoma are associated with a better prognosis. The prediction of the nomogram is good.

14.
Article in Chinese | WPRIM | ID: wpr-816074

ABSTRACT

OBJECTIVE: To investigate the prognostic factors of esophageal cancer with multiple organ metastases and establish a prognostic prediction model. METHODS: Patients data were extracted from the SEER database. The clinical data of 388 patients with esophageal cancer with multiple organ metastases were retrospectively analyzed. Risk factors were analyzed by log-rank method and survival curves were drawn by K-M method. Multivariate analysis was performed by Cox proportional hazard model to obtain independent prognostic factors for multi-organ metastasis of esophageal cancer. A prediction nomogram was further established.RESULTS: The mean survival time of patients in this study was 7.3 months, and the survival rates for 1-, 3-, and 5-year were 15.5%,1.2%, and 0, respectively. Age was an independent prognostic factor. The value of C-index was 0.618. CONCLUSION: The prognosis of esophageal cancer with multiple organ metastases is poor. Age at the diagnosis and patterns of multiple organ metastases are related to the survival time of patients. The prediction nomogram provided a good prognosis prediction.

15.
Chinese Journal of Lung Cancer ; (12): 600-609, 2018.
Article in Chinese | WPRIM | ID: wpr-772394

ABSTRACT

BACKGROUND@#The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients' prognosis.@*METHODS@#We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma.@*RESULTS@#1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively.@*CONCLUSIONS@#Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.


Subject(s)
Aged , Aged, 80 and over , Carcinoma, Adenosquamous , Diagnosis , Epidemiology , Pathology , Therapeutics , Databases, Factual , Female , Humans , Lung Neoplasms , Diagnosis , Epidemiology , Pathology , Male , Middle Aged , Neoplasm Staging , Prognosis , Survival Analysis
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