RESUMO
Cutaneous angiosarcoma is an aggressive malignant mesenchymal vasoformative neoplasm that accounts for 1% of all soft tissue sarcomas. Using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program, we analyzed the demographics and survival of cutaneous angiosarcoma. The Surveillance, Epidemiology, and End Results program recorded 434 cases of cutaneous angiosarcoma from 1973 to 2007. The incidence was nearly the same in men (222 cases) and women (212 cases). Most patients were white (88%) with a mean age of 73 years. African Americans made up only 4% of the cases. Two hundred seventy (62%) cases were tumors of the head and neck, whereas 106 (24%) cases arose in the skin of the trunk. Grade was recorded in 194 cases (45%): 28 were grade I, 44 were grade II, 60 were grade III, and 62 were grade IV. Survival rates of cutaneous angiosarcoma correlated with age, anatomical site, and stage of disease. Patients younger than 50 years had a 10-year relative survival rate of 71.7%, whereas patients 50 years and older had a 36.8% 10-year survival rate. Tumors of the scalp and neck resulted in a 13.8% 10-year relative survival rate, whereas tumors arising in the trunk resulted in a 75.3% 10-year survival rate. Tumors localized to the skin had better prognosis (53.6% 10-year relative survival rate) than those with regional or distant stage (19.0% and 6.2%). Twenty-six percent of patients with angiosarcoma had a prior primary. Cutaneous angiosarcomas arise predominantly in the head and neck of white individuals older than 60 years.
Assuntos
Hemangiossarcoma/epidemiologia , Sarcoma/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano , Idoso , Idoso de 80 Anos ou mais , Feminino , Hemangiossarcoma/mortalidade , Hemangiossarcoma/patologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Vigilância da População/métodos , Prognóstico , Estudos Retrospectivos , Programa de SEER , Sarcoma/mortalidade , Sarcoma/patologia , Distribuição por Sexo , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Fatores de Tempo , Resultado do Tratamento , População Branca , Adulto JovemRESUMO
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine tumor arising predominantly on sun-exposed skin of older and usually immunosuppressed individuals. METHODS: Using data from NCI's SEER (Surveillance, Epidemiology, and End Results) Program from 1973 to 2006, we analyzed the demographics and survival of MCC. RESULTS: SEER had recorded 3870 cases of MCC. The incidence was higher in men (2380 cases, 61.5%) than in women (1490 cases, 38.5%). Most patients were White (94.9%) between 60 and 85 years of age. MCC was rare in Blacks. The most common location was the head and neck. The salivary glands, nasal cavity, lip, lymph nodes, vulva, vagina and esophagus were the most common extracutaneous sites. The 10-year relative survival rate was higher in women than men (64.8% vs. 50.5%, p < 0.001). Patients 50-69 years had the highest 10-year relative survival rate (59.6%). Stage of disease was the best predictor of survival. CONCLUSIONS: MCC arises predominantly in the skin of head and neck in White men above 70 years of age. Cases also occurred in extracutaneous sites. Age did not predict survival, yet gender, site and tumor size revealed clear differences. The most significant predictor of survival was tumor stage.
Assuntos
Carcinoma de Célula de Merkel , Neoplasias Cutâneas , Carcinoma de Célula de Merkel/epidemiologia , Carcinoma de Célula de Merkel/mortalidade , Carcinoma de Célula de Merkel/patologia , Demografia , Etnicidade , Feminino , Humanos , Masculino , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Taxa de Sobrevida , Estados Unidos/epidemiologiaRESUMO
Primary neuroendocrine tumors of the gallbladder (GB) and extrahepatic biliary ducts (EHBDs) include carcinoid tumors and small-cell carcinomas (SCCs). They are uncommon, and therefore, little is known about their demographics and clinical course. From National Cancer Institute's Surveillance, Epidemiology, and End Results program (1973-2005), we analyzed the demographics and 10-year relative survival rates of carcinoids and SCCs of the GB and EHBD according to histologic type and stage. There were 119 cases of carcinoid tumors and 54 cases of SCCs in the GB. There were 31 carcinoid tumors and 17 SCCs in the EHBD. The female/male ratios of carcinoids in the GB and EHBD were 2.4 and 1.6, respectively. The ratios for SCC in the GB and EHBD were 2.2 and 1.1, respectively. For the GB, the mean age of diagnosis for carcinoids was 64.5, and for SCC, it was 67.5. For the EHBD, the mean age was 58.2 for carcinoids and 68.4 for SCC. The 10-year survival rates were 36% for carcinoid tumors of the GB and 80% for carcinoid tumors of the EHBD. For SCC, the 10-year survival was 0% in the GB and EHBD. Carcinoid tumors and SCC of the extrahepatic biliary tree are uncommon neoplasms that differ in their demographics and biologic behavior, supporting the distinction of these 2 histopathologic types. Therefore, these tumors should be separately classified and not included in the single generic group of neuroendocrine carcinoma.
Assuntos
Neoplasias dos Ductos Biliares/epidemiologia , Ductos Biliares Extra-Hepáticos/patologia , Tumor Carcinoide/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Neoplasias da Vesícula Biliar/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias dos Ductos Biliares/patologia , Tumor Carcinoide/patologia , Carcinoma de Células Pequenas/patologia , Feminino , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Programa de SEER , Taxa de Sobrevida , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Cancers of the ampulla are unusual and morphologically heterogeneous. The NCI's SEER Program is now large enough so that unusual cancers can be studied. Based on pathologic and epidemiologic characteristics of cancer of the ampulla available in SEER, important clinicopathological correlations can be made. METHODS: All patients with cancer of the ampulla were identified between 1973 and 2005. Demographic features, distribution of histological types, age-specific incidence rates, and 5-year survival rates according to stage and histologic type were compared. RESULTS: There were 5,625 cases of ampullary cancer. Ampullary cancer has been increasing since 1973. In both African Americans and Caucasians, the disease is more common in men. Adenocarcinomas, NOS comprised 65% of all histological types. Survival depends on stage, grade, and histologic type. Papillary carcinomas had a more favorable survival than other types; carcinomas arising in adenomas had a more favorable survival than adenocarcinomas not associated with adenomas. Logarithmic transformation of age-related incidence data demonstrates that cancers having differing histopathologic phenotypes represent a single population of tumors. CONCLUSIONS: Prognostic factors include histologic type, grade, stage, and coexisting adenomas. These data should be included in pathology reports. Although certain histologic types exhibit morphologic differences, their pathogenesis appears to be similar.
Assuntos
Ampola Hepatopancreática/patologia , Carcinoma/mortalidade , Neoplasias do Ducto Colédoco/mortalidade , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , População Negra/estatística & dados numéricos , Carcinoma/patologia , Neoplasias do Ducto Colédoco/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Programa de SEER , Distribuição por Sexo , Taxa de Sobrevida , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
Thyroid carcinomas with follicular phenotype have demonstrated changing patterns over 30 years (1973-2003) according to data from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Papillary carcinomas have significantly increased. They accounted for 74% of all cases of thyroid cancers in 1973 and 87% in 2003. During this period, the incidence rate of papillary carcinoma (including the follicular variant) increased by 189%, the rate of follicular carcinoma remained stable, and the rate of anaplastic carcinoma decreased by 22%. The rate of the follicular variant of papillary carcinoma alone increased by 173%. Thyroid cancer was more common in whites than in blacks and in females more than in males. Papillary carcinomas rapidly increased during adolescence and reached a peak around age 52-56, then declined. Follicular carcinomas increased steadily, but at a lower rate until age 80. After 1988, both papillary and follicular carcinomas, less than 2 cm, increased at the same rate as carcinomas larger than 2 cm. However, papillary carcinomas less than 2 cm were more common. Overall, the 10-year relative survival rate was greater than 90% for blacks and whites with the exception of follicular carcinoma in blacks. The 10-year relative survival rate for anaplastic carcinoma in patients over 40 years of age was 4.7%. The decrease in incidence rate of anaplastic carcinoma may be the result of the successful treatment of papillary and follicular carcinomas.