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Clinical Characteristics, Prognosis, and Nomogram for Esophageal Cancer Based on Adenosquamous Carcinoma: A SEER Database Analysis.

ABSTRACT: Objective: Esophageal adenosquamous carcinoma (ASC) is a rare pathological type of cancer. Its clinical features and prognosis is poorly understood. The purpose of this study was to identify the characteristics of ASC patients and analyze the risk factors of esophageal carcinoma. Methods: Patients with esophageal cancer in the SEER database diagnosed from 1975-2016 were obtained. The epidemiology, clinical characteristics, and outcomes between these three groups were compared. The nomogram and online dynamic nomogram were constructed according to the Cox proportional hazard model. Results: The age-adjusted incidences of AC (1975-1999), AC (1999-2016), and ASC (1975-1989) increased over time (p < 0.05). Age-adjusted incidences of SqCC (1986-2012) and ASC (1989-2016) decreased (p < 0.05). Survival of patients with ASC was significantly worse when compared to AC and SqCC (ASC vs. AC, p < 0.001, ASC vs. SqCC, p = 0.01). ASC, older age, black race, male, overlapping site, higher tumor grade, lymph node metastasis, and a higher summary stage or AJCC stage were considered to be risk factors for a poor survival in the multivariate Cox analysis. The ROC curves and AUC indicated that the model has a good discrimination ability (AUC were 0.774 for a 3-year OS and 0.782 for a 5-year OS). An online dynamic nomogram was built based on the Cox proportional hazard model for convenient clinical use. Conclusions: ASC is somewhat closer to AC rather than SqCC in terms of the demographics and tumor site, but has a worse OS than both AC and SqCC.

SUBMITTER: Qian H

PROVIDER: S-EPMC8107687 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundPulmonary large cell carcinoma (LCC) is an infrequent neoplasm with a poor prognosis. This study explored the clinical characteristics and survival prognostic factors of LCC patients.MethodsPatient data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Chi-square tests or rank-sum tests were used to compare differences in clinical characteristics. Log-rank tests, univariate, and multivariate analyses were performed to investigate the independent factors of survival. Analyses of stage I-IV patients were performed to further explore the optimal treatment.ResultsIn total, 3197 LCC patients were included in this analysis. Compared with other non-small cell lung cancers (NSCLCs), there was a worse overall survival (OS) from LCC. LCC was more common in males, over age 60 and in the upper lobe. A total of 73.6% of patients were stage III/IV. The median OS of stage I-IV patients was 42 months, 22 months, 11 months, and three months, respectively. The elderly, males, later stage, and main bronchus location, or overlapping lesions were risk factors for survival prognosis. In stage I-III patients, treatment including surgery could significantly reduce the risk of death by 60% at least compared with no therapy. Surgery was still beneficial for stage IV patients, and the hazard ratio (HR) compared with no therapy was 0.462 (P = 0.001).ConclusionsOur study concluded that LCC has unique clinical features, and that age, sex, primary site, stage, and treatment are significantly related to OS. Surgery based comprehensive treatments are effective for LCC.Key pointsSignificant findings of the study In stage IV patients, chemotherapy or radiotherapy combined with surgery could further improve survival. When surgical resection involved more than one lobe, it may be beneficial for survival prognosis. What this study adds LCC patients were principally male and over age 60, with later stages and poor survival prognosis. Age, sex, stage, primary site and therapy are closely related to survival.

Project description:Ewing's sarcoma is a high-grade malignancy bone and soft tissue tumor that most commonly occurs in children and adolescents. Although the overall prognosis of Ewing's sarcoma has improved, the 5-year survival rate has not improved significantly. The study aimed to determine the risk factors independently associated with the prognosis of Ewing's sarcoma and to construct a nomogram to predict patient survival. Patients diagnosed with Ewing's sarcoma were collected from the Surveillance, Epidemiology, and End Results program database between 2004 and 2015 and further divided into training and validation cohort. Univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors. The nomogram was used to predict 3- and 5-year overall survival (OS) and cancer-specific survival (CSS). Finally, the nomogram was verified internally and externally through the training and validation cohorts, and the predictive capability was evaluated using the receiver operating characteristic (ROC) curve, C-index, and calibration curve and compared with that of the 7th TNM stage. A total of 1120 patients were divided into training (n = 713) and validation (n = 407) cohorts. Based on the multivariate analysis of the training cohort, a nomogram that integrated age, tumor size, primary site, N stage, and M stage was constructed (P < 0.05). The predicted C-indexes of OS and CSS of the training cohort were 0.744 (95% CI 0.717-0.771) and 0.743 (95% CI 0.715-0.770), respectively. However, the TNM stage had a C-index of 0.695 (95% CI 0.666-0.724) and 0.698 (95% CI 0.669-0.727) for predicting OS and CSS, respectively. The nomogram showed higher C-indexes than those in the TNM stage. Furthermore, the internal and external calibration curves showed good consistency between the predicted and observed values. Age, tumor size, primary site, N stage, and M stage are independent risk factors affecting the OS and CSS in Ewing's sarcoma patients. Compared with the 7th TNM staging, the nomogram consisting of these factors was more accurate for risk assessment and survival prediction in patients with Ewing's sarcoma, thus providing a novel reliable tool for risk assessment and survival prediction in Ewing's sarcoma patients.

Project description:BackgroundHepatoblastoma (HB), hepatocellular carcinoma (HCC), and embryonal sarcoma (ES) are the three main types of liver tumors in children and adolescents. At present, epidemiological knowledge and predictors of these three liver tumor types in multi-ethnic populations are limited. This study aimed to outline the clinical features and construct a prognostic nomogram for these tumors, which can contribute to the prediction of dynamic overall survival probability during the follow-up period.MethodsA total of 1,122 patients liver tumor patients between 2000 to 2019 in Surveillance, Epidemiology, and End Results (SEER) database were enrolled for the current study, and separated into 824 HB, 219 HCC, and 79 ES according to the type of pathology. Independent prognostic factors were screened by univariate and multivariate Cox regression analysis, and a prognostic nomogram was constructed for overall survival. The accuracy and discriminative abilities of the nomogram were evaluated by concordance index as well as time-dependent receiver operating characteristic curves and calibration curves.ResultsRace (P=0.0016), surgery [hazard ratio (HR): 0.1021, P<0.001], and chemotherapy (HR: 0.27, P=0.00018) are independent prognostic factors for hepatoblastoma. Pathological tissue grading (P=0.00043), tumor node metastasis (TNM) staging (P=0.00061), and surgery are independent prognostic factors for hepatocellular carcinoma. Household income and surgery (HR: 0.1906, P<0.001) are independent prognostic factors for embryonal sarcoma. All of these prognostic factors are significantly associated with prognosis. A nomogram consisting of these variables was established, which showed a good concordance index (0.747, 0.775, and 0.828 in hepatoblastoma, hepatocellular carcinoma, and embryonal sarcoma, respectively). Also, the 5-year area under curve (AUC) of the nomogram were 0.738, 0.812, and 0.839 in hepatoblastoma, hepatocellular carcinoma, and embryonal sarcoma, respectively. In the calibration diagram, an optimal agreement between the nomogram-predicted and actual observed survival was evident.ConclusionsWe developed an effective prognostic nomogram for overall survival prediction in hepatoblastoma, hepatocellular carcinoma, and embryonal sarcoma in children and adolescent patients, which will further benefit the assessment of long-term outcomes.

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Clinical Characteristics, Prognosis, and Nomogram for Esophageal Cancer Based on Adenosquamous Carcinoma: A SEER Database Analysis.

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