Dataset Information

Prognostic Factors of Survival for High-Grade Neuroendocrine Neoplasia of the Bladder: A SEER Database Analysis.

ABSTRACT: Background: High-grade neuroendocrine carcinoma (NEC) is a rare and aggressive variant of bladder cancer. Considering its rarity, its therapeutic management is challenging and not standardized. Methods: We analyzed data extracted from the Surveillance, Epidemiology, and End Results (SEER) registry to evaluate prognostic factors for high-grade NEC of the bladder. Results: We extracted data on 1134 patients: 77.6% were small cell NEC, 14.6% were NEC, 5.5% were mixed neuro-endocrine non-neuroendocrine neoplasia, and 2.3% were large cell NEC. The stage at diagnosis was localized for 45% of patients, lymph nodal disease (N+M0) for 9.2% of patients, and metastatic disease for 26.1% of patients. The median overall survival (OS) was 12 months. Multivariate analysis detected that factors associated with worse OS were age being >72 years old (HR 1.94), lymph nodal involvement (HR 2.01), metastatic disease (HR 2.04), and the size of the primary tumor being >44.5 mm (HR 1.80). In the N0M0 populations, the size of the primary tumor being <44.5 mm, age being <72 years old, and major surgery were independently associated with a lower risk of death. In the N+M0 group, the size of the primary lesion was the only factor to retain an association with OS. Conclusions: Our SEER database analysis evidenced prognostic factors for high-grade NEC of the bladder that are of pivotal relevance to guide treatment and the decision-making process.

SUBMITTER: Mollica V

PROVIDER: S-EPMC9406377 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Prognostic Factors of Survival for High-Grade Neuroendocrine Neoplasia of the Bladder: A SEER Database Analysis.

Mollica Veronica V Massari Francesco F Andrini Elisa E Rosellini Matteo M Marchetti Andrea A Nuvola Giacomo G Tassinari Elisa E Lamberti Giuseppe G Campana Davide D

Current oncology (Toronto, Ont.) 20220818 8

Background: High-grade neuroendocrine carcinoma (NEC) is a rare and aggressive variant of bladder cancer. Considering its rarity, its therapeutic management is challenging and not standardized. Methods: We analyzed data extracted from the Surveillance, Epidemiology, and End Results (SEER) registry to evaluate prognostic factors for high-grade NEC of the bladder. Results: We extracted data on 1134 patients: 77.6% were small cell NEC, 14.6% were NEC, 5.5% were mixed neuro-endocrine non-neuroendocr ...[more]

PMID: 36005199

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Project description:IntroductionMixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is a rare form of neuroendocrine neoplasms (NENs). The purpose of this study was to investigate the characteristics and survival profile of appendiceal MiNENs, with a view of providing robust clinical features of this rare disease.MethodsPatients were selected from the Surveillance, Epidemiology, and End Results database (2004-2016). The prognosis of MiNEN (n = 315) was compared with other histological subtypes including neuroendocrine tumor (NETs) (n = 1734), neuroendocrine carcinoma (NECs) (n = 375), goblet cell carcinoid (GCC) (n = 968), signet ring cell carcinoma (n = 463), mucinous adenocarcinoma (MAC) (n = 2355), and non-mucinous adenocarcinoma (NMAC) (n = 1187) in the appendix. Age-adjusted incidence was calculated using Joinpoint regression. The Cox proportional hazards model and the Fine-Gray competing risk model were used to perform overall survival (OS) and cancer-specific mortality (CSM) analyses, respectively.ResultsThe age-adjusted incidence of MiNENs increased from 0.01/100,000 person-years in 2004 to 0.07/100,000 person-years in 2016. The 3-, 5-, and 10-year OS rates for MiNENs were 69.5, 57.4, and 43.7%, respectively, and the corresponding CSM rates were 23.1, 36.4, and 45.1%, respectively. Multivariate analysis revealed that the prognosis of MiNENs was worse than that of NETs, NECs, GCC, and MAC but better than that of NMAC and signet ring cell carcinoma. Tumor extension was the only independent factor influencing the prognosis of MiNENs, but tumor size, grade, and surgical approaches were not. Moreover, when compared with local excision or appendectomy, extensive surgery such as hemicolectomy or colectomy did not prolong the survival of individuals with MiNENs.ConclusionMiNEN is a rare but aggressive tumor with a poor prognosis differing from NENs, GCC and adenocarcinomas. To improve the prognosis of the disease, early diagnosis and comprehensive evaluation are necessary.

Project description:BackgroundDespite high-grade serous ovarian carcinoma (HGSOC) being the most common epithelial ovarian cancer, it is a heterogenous group of tumors with several histological subtypes. The goal of our study was to develop specifical models to predict the survival of actively treated, HGSOC.MethodsThis retrospective cohort study included patients with HGSOC who had undergone surgery and chemotherapy between the years of 2010 and 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. A total of 3,788 cases were randomly divided into a training (n=2,591) and test set (n=1,197). Cox-LASSO algorithm and cross validation (based on lambda.1se) were used to identify survival factors in the training set. Nomograms were created and internally validated. We used Harrell's C-statistic to assess discrimination. The performance of each nomogram was evaluated using calibration plots. The clinical benefit of our models was evaluated using a decision curve analysis.ResultsThe significant prognostic factors were marital status, age, lymph node (LN) dissection, tumor size, residual disease, and the International Federation of Obstetrics and Gynecology (FIGO) stage, which were utilized to develop the nomogram for accurately predicting 3- and 5-year overall survival (OS). Among the above factors, except for marital status, the others were included in the model for cancer-specific survival (CSS). The C-indices for OS and CSS achieved 0.679 [95% confidence interval (CI): 0.660 to 0.699] and 0.678 (95% CI: 0.658 to 0.698), respectively, in the training set and 0.662 (95% CI: 0.633 to 0.690) and 0.680 (95% CI: 0.653 to 0.707), respectively, in the test set. The good consistency was illustrated using calibration plots. In comparison with models including only FIGO or the AJCC staging system, C-index in our study were increased by 4.5-7.0% for the development test and by 6.7-7.9% for the validation test. In addition, the nomograms had a bigger range of threshold probabilities in the decision curve analysis (DCA) curves. The high-risk subgroup had significantly less favorable survival than the low-risk subgroup.ConclusionsThe present study indicated that the low-cost nomograms could be used as a potential prognostic tool specially for predicting survival in patients with HGSOC. Given the relatively small C-index, we still need to build a more accurate model to predict survival of HGSOC.

Project description:BackgroundLung adenocarcinoma (ADC) is the main cause of death related to lung cancer. The aim of this study was to identify poor prognostic factors for overall survival (OS) in patients with stage IV lung ADC in real-world clinical practice.MethodsPatients were selected from the Surveillance Epidemiology and End Results (SEER) database. Chi-square bivariate analysis was used for the association of binary qualitative variables. A multivariate Cox regression analysis was performed to determine the impact of these prognostic factors on OS.ResultsA total of 46 030 patients were included (51.3% men, mean age 67.03 ± 11.6), of whom 41.3% presented with metastases in bone, 28.9% in brain, 17.1% in liver and 31.8% in lung. Patients with liver metastases presented with two or more metastatic sites more frequently than patients without liver metastases (P < 0.001). Male sex (HR 0.78, 95% CI: 0.76-0.80), age ≥ 65 years (HR 1.37, 95% CI: 1.33-1.40), lack of family support (HR 0.80, 95% CI: 0.78-0.81) and presence of liver (HR 1.45, 95% CI: 1.40-1.50), bone (HR 1.21, 95% CI: 1.18-1.24) or brain metastases (HR 1.18, 95% CI: 1.15-1.21) were identified as poor prognostic factors for OS. Patients with liver metastasis showed the highest hazard ratio value (P < 0.001).ConclusionsThe presence of liver metastases was the worst prognostic factor for patients with metastatic lung ADC. This factor should be considered as a stratification factor for future studies evaluating new cancer treatments including immunotherapy.Key pointsSIGNIFICANT FINDINGS OF THE STUDY: Regression analysis identified poor prognostic factors for overall survival. Factors were male sex, age ≥ 65 years, lack of family support and presence of liver, bone and brain metastases. Patients with liver metastasis showed the highest HR (HR = 1.45 95% CI: 1.40-1.50). This study included the highest number of adenocarcinoma patients analyzed so far (N = 46 030). What this study adds The presence of liver metastases should be considered as a stratification factor for future studies evaluating new cancer treatments including immunotherapy.

Project description:ObjectiveNeuroendocrine carcinoma of the cervix (NECC) is extremely rare in clinical practice. This study aimed to methodologically analyze the clinicopathological factors associated with NECC patients and to develop a validated survival prediction model.MethodsA total of 535 patients diagnosed with NECC between 2004 and 2016 were identified from the Surveillance, Epidemiology and End Results (SEER) database, while 122 patients diagnosed with NECC at Yunnan Cancer Hospital (YCH) from 2006 to 2019 were also recruited. Patients from the SEER database were divided into a training cohort (n = 376) and a validation cohort (n = 159) in a 7:3 ratio for the construction and internal validation of the nomogram. External validation was performed in a cohort at YCH. The Kaplan-Meier method was used for survival analysis, the Log-rank method test was used for univariate analysis of prognostic influences, and the Cox regression model was used for multivariate analysis.ResultsThe 3-year and 5-year overall survival (OS) rates for patients with NECC in SEER were 43.6% and 39.7%, respectively. In the training cohort, multivariate analysis showed independent prognostic factors for NECC patients including race, tumor size, distant metastasis, stage, and chemotherapy (p<0.05). For extended application in other cohorts, a nomogram including four factors without race was subsequently created. The consistency index (C-index) of the nomogram predicting survival was 0.736, which was well-validated in the validation cohorts (0.746 for the internal validation cohort and 0.765 for the external validation cohort). In both the training and validation cohorts, the 3-year survival rates predicted by the nomogram were comparable to the actual ones. We then succeeded in dividing patients with NECC into high- and low-risk groups concerning OS using the nomogram we developed. Besides, univariate analysis showed that chemotherapy ≥4 cycles may improve the OS of patients at YCH with NECC.ConclusionWe successfully constructed a nomogram that precisely predicts the OS for patients with NECC based on the SEER database and a large single-center retrospective cohort. The visualized and practical model can distinguish high-risk patients for recurrence and death who may benefit from clinical trials of boost therapy effectively. We also found that patients who received more than 4 cycles of chemotherapy acquired survival benefits than those who received less than 4 cycles.

Dataset Information

Prognostic Factors of Survival for High-Grade Neuroendocrine Neoplasia of the Bladder: A SEER Database Analysis.

Publications

Prognostic Factors of Survival for High-Grade Neuroendocrine Neoplasia of the Bladder: A SEER Database Analysis.

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