scholarly journals Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study

2020 ◽  
Author(s):  
Jiahui Chen ◽  
Anqiang Wang ◽  
Ke Ji ◽  
Zhaode Bu ◽  
Jiafu Ji
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Neoadjuvant Therapy ◽  
Gastric Adenocarcinoma ◽  
Neuroendocrine Carcinoma ◽  
Gastric Neoplasms ◽  
Gastric Adenocarcinomas ◽  
The Difference ◽  
Mixed Tumors ◽  
Surgical Group

Abstract Background Gastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma.Methods Surgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group.Results The OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant.Conclusions Gastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating that these neoplasms are more malignant than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.

scholarly journals Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study

2020 ◽  
Author(s):  
Jiahui Chen ◽  
Anqiang Wang ◽  
Ke Ji ◽  
Zhaode Bu ◽  
Jiafu Ji
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Neoadjuvant Therapy ◽  
Gastric Adenocarcinoma ◽  
Neuroendocrine Carcinoma ◽  
Gastric Neoplasms ◽  
Gastric Adenocarcinomas ◽  
The Difference ◽  
Mixed Tumors ◽  
Surgical Group

Abstract BackgroundGastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma.MethodsSurgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group.ResultsThe OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant.ConclusionsGastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.

scholarly journals Comparison of overall survival of gastric neoplasms containing neuroendocrine carcinoma components with gastric adenocarcinoma: a propensity score matching study

2020 ◽  
Author(s):  
Jiahui Chen ◽  
Anqiang Wang ◽  
Ke Ji ◽  
Zhaode Bu ◽  
Jiafu Ji
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Neoadjuvant Therapy ◽  
Gastric Adenocarcinoma ◽  
Neuroendocrine Carcinoma ◽  
Gastric Neoplasms ◽  
Gastric Adenocarcinomas ◽  
The Difference ◽  
Mixed Tumors ◽  
Surgical Group

Abstract Background Gastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and a poor prognosis and include pure NEC and mixed tumors containing NEC components. We aimed to investigate whether there is a distinct difference in overall survival (OS) between gastric neoplasms containing NEC components and gastric adenocarcinoma. Methods Surgically resected gastric neoplasms containing NEC components (n=180) and gastric adenocarcinomas (n=785) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analysed. Patients were categorized into a surgical group and a neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC and mixed tumors with less than 30% (<30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (>70% G-HMiNEN) neuroendocrine carcinoma components. OS was compared between these groups and the gastric adenocarcinoma group. Results The OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinomas in the surgical group, regardless of whether the percentage of neuroendocrine cancer components was less than 30%, between 30% and 70%, more than 70% or 100%. Cox multivariable regression analysis suggested that tumor category (neoplasms containing NEC components or gastric adenocarcinoma) was an independent risk factor for prognosis. Interestingly, among patients receiving neoadjuvant therapy, the difference was not significant. Conclusions Gastric neoplasms containing any proportion of NEC components had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma. Among the patients receiving neoadjuvant therapy, the difference in overall survival was not significant, which was in sharp contrast with the results of the surgery group, suggesting that neoadjuvant therapy may have a good effect in the treatment of these neoplasms.

scholarly journals Comparison of Overall Survival of Gastric Neoplasms Containing Neuroendocrine Carcinoma Components with Gastric Adenocarcinoma: A Propensity Score Matching Study

2020 ◽  
Author(s):  
Jiahui Chen ◽  
Anqiang Wang ◽  
Ke Ji ◽  
Zhaode Bu ◽  
Jiafu Ji
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Gastric Adenocarcinoma ◽  
Neuroendocrine Carcinoma ◽  
Multivariate Regression Analysis ◽  
Gastric Neoplasms ◽  
Peking University ◽  
The Difference ◽  
Surgical Group

Abstract Background Gastric neoplasms containing neuroendocrine carcinoma (NEC) components are rare malignancies with highly aggressive behavior and poor prognosis, including pure NEC and mixed tumor containing NEC components. We attempt to investigate whether there is a distinct difference in overall survival (OS) between Gastric neoplasms containing NEC components and gastric adenocarcinoma.Methods Surgically resected gastric neoplasms containing NEC components (n = 54) and gastric adenocarcinoma (n = 600) from January 2013 to December 2019 at Peking University Cancer Hospital were retrospectively analyzed. Patients were categorized into the surgical group and the neoadjuvant group and adjusted using propensity score matching. In the two groups, gastric neoplasms containing NEC components were divided into pure NEC, mixed tumors with neuroendocrine carcinoma components less than 30% (< 30% G-HMiNEN), between 30% and 70% (G-HMiNEN) and more than 70% (> 70% G-HMiNEN). OS was compared between these groups and gastric adenocarcinoma.Results The OS of gastric neoplasms containing neuroendocrine NEC components was poorer than that of gastric adenocarcinoma in the surgical group, whether the ratio of neuroendocrine cancer components was less than 30%, between 30% and 70%, higher than 70% or 100%. Cox multivariate regression analysis proved tumor category (neoplasms containing NEC components or gastric adenocarcinoma) to be an independent risk factor for prognosis. In patients receiving neoadjuvant therapy, however, the difference was not significant.Conclusions Gastric neoplasms containing NEC components, regardless of the proportion of neuroendocrine carcinoma components, had poorer overall survival than gastric adenocarcinoma in patients treated with surgery directly, indicating a higher degree of malignancy than gastric adenocarcinoma.

Neoadjuvant Therapy Followed by Resection Versus Upfront Resection for Resectable Pancreatic Cancer: A Propensity Score Matched Analysis

2017 ◽  
Vol 35 (5) ◽  
pp. 515-522 ◽  
Author(s):  
Ali A. Mokdad ◽  
Rebecca M. Minter ◽  
Hong Zhu ◽  
Mathew M. Augustine ◽  
Matthew R. Porembka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Early Stage ◽  
Clinical Stage ◽  
Pancreatic Head ◽  
Hazard Ratio ◽  
Stage I

Purpose To compare overall survival between patients who received neoadjuvant therapy (NAT) followed by resection and those who received upfront resection (UR)—as well as a subgroup of UR patients who also received adjuvant therapy—for early-stage resectable pancreatic adenocarcinoma. Patients and Methods Adult patients with resected, clinical stage I or II adenocarcinoma of the head of the pancreas were identified in the National Cancer Database from 2006 to 2012. Patients who underwent NAT followed by curative-intent resection were matched by propensity score with patients whose tumors were resected upfront. Overall survival was compared by using a Cox proportional hazards regression model. Early postoperative and oncologic outcomes were evaluated. Results We identified 15,237 patients with clinical stage I or II resected pancreatic head adenocarcinoma. From the NAT group, 2,005 patients (95%) were matched with 6,015 patients who underwent UR. The NAT group was associated with improved survival compared with UR (median survival, 26 months v 21 months, respectively; stratified log-rank P < .01; hazard ratio, 0.72; 95% CI, 0.68 to 0.78). Patients in the UR group had higher pathologic T stage (pT3 and T4: 86% v 73%; P < .01), higher positive lymph nodes (73% v 48%; P < .01), and higher positive resection margin (24% v 17%; P < .01). Compared with a subset of UR patients who received adjuvant therapy, NAT patients had a better survival (adjusted hazard ratio, 0.83; 95% CI, 0.73 to 0.89). Conclusion NAT followed by resection has a significant survival benefit compared with UR in early-stage, resected pancreatic head adenocarcinoma. These findings support the use of NAT, particularly as a patient selection tool, in the management of resectable pancreatic adenocarcinoma.

The Role of Neoadjuvant Versus Adjuvant Therapy for Duodenal Adenocarcinoma: A National Cancer Database Propensity Score Matched Analysis

2020 ◽  
pp. 000313482095482
Author(s):  
Kimberly Linden ◽  
Atlee Melillo ◽  
John Gaughan ◽  
Chioma Obinero ◽  
Alec Kellish ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Surgical Resection ◽  
Retrospective Review ◽  
National Cancer Database ◽  
Tumor Characteristics ◽  
Duodenal Adenocarcinoma

Introduction Adjuvant therapy is recommended in duodenal adenocarcinoma (DA), but the role of neoadjuvant therapy remains undefined. We compared the effect of neoadjuvant therapy to adjuvant therapy on overall survival, 30-day, and 90-day mortality following the resection of DA. Methods A retrospective review of the National Cancer Database was performed on patients with DA who received either adjuvant or neoadjuvant therapy in addition to surgical resection. Propensity score matching was done for patient, socioeconomic, and tumor characteristics. Overall survival, 30-day, and 90-day mortality were compared. Results A total of 112 patients were identified; 55 received adjuvant therapy; 57 received neoadjuvant therapy. There was no difference in 30-day (0% vs. 1.75%; P = 1.00), 90-day mortality (1.82% vs. 7.02%; P = .36), nor overall survival (1 yr: 86% vs. 76; 3 yr: 49% vs. 46%; 5 yr: 42% vs. 39%; P = .28). Conclusions There was no difference in overall survival after propensity score matched analysis.

scholarly journals Immune Cell Infiltrate and Prognosis in Gastric Cancer

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3604
Author(s):  
Niko Kemi ◽  
Niko Hiltunen ◽  
Juha P. Väyrynen ◽  
Vesa-Matti Pohjanen ◽  
Olli Helminen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Gastric Adenocarcinoma ◽  
Prognostic Value ◽  
Immune Cell ◽  
Cox Regression ◽  
Diffuse Type ◽  
Hazard Ratios ◽  
The Difference ◽  
Immune Cell Score

Purpose: To examine and compare the prognostic value of immune cell score (ICS) and Klintrup–Mäkinen (KM) grade in gastric cancer. Methods: Gastric adenocarcinoma tissues from samples of 741 patients surgically treated in two hospitals in Finland were assessed for ICS and KM grade. Cox regression with adjustment for confounders provided hazard ratios (HRs) and 95% CIs. Subgroup analyses were performed in intestinal and diffuse type subgroups. The primary outcome was 5-year overall survival. Results: High ICS was associated to longer 5-year survival (adjusted HR 0.70, 95% CI 0.52–0.94), compared to low ICS. The difference was significant in intestinal type subgroup (adjusted HR 0.54, 95% CI 0.36–0.81) but not in diffuse type subgroup (adjusted HR 0.92, 95% CI 0.58–1.46). High KM grade was an independent prognostic factor for longer 5-year overall survival (adjusted HR 0.59, 95% CI 0.45–0.77) in both intestinal (adjusted HR 0.61, 95% CI 0.44–0.85) and diffuse subgroups (adjusted HR 0.52, 95% CI 0.31–0.86). ICS and KM grade were moderately correlated (ρ = 0.425). When both immune cell score and KM grade were included in the regression analysis, only KM grade remained prognostic. Conclusions: Both ICS and KM grade are prognostic factors in gastric adenocarcinoma, but immunohistochemistry-based ICS might not have additional prognostic value over hematoxylin–eosin-based KM grade.

Prognostic similarities between gastric adenosquamous carcinoma and typical gastric adenocarcinoma: A large population-based and propensity score-matched study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16559-e16559
Author(s):  
Feng Zhao ◽  
Jili Wang ◽  
Xiaofei Cheng ◽  
Xinke Li ◽  
Zhongjie Lu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Propensity Score ◽  
Gastric Adenocarcinoma ◽  
Adenosquamous Carcinoma ◽  
Large Population ◽  
Population Based ◽  
Chemotherapy Patients ◽  
Cox Analysis ◽  
Matched Study

e16559 Background: Gastric adenosquamous carcinoma (ASC) is an extremely rare form of stomach malignancy. To date, the limited knowledge of its biology and outcomes stems from mostly small, single institution experiences. We analyzed the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016 to explore the treatment of ASC together with its prognostic factors to gain relatively large and consolidated insights. Methods: Propensity score matching (PSM) and Kaplan–Meier analyses were used to compare the prognosis between gastric ASC and typical gastric adenocarcinoma (AC). We assessed overall survival (OS) after patient stratification according to summary stage and treatment choice. Cox hazards regression analysis was performed to determine independent predictors of overall survival (OS). Results: A total of 171 gastric ASC were included (mean 65.20 ± 11.71 years-of-age). Patients with gastric ASC had similar OS to matched individuals with typical gastric AC (p = 0.915). In terms of treatment, 45.6% of gastric ASC patients underwent surgery, and 37.4% received radiotherapy (RT), and 64.3% received chemotherapy. Patients who underwent surgery had longer OS than those who did not receive surgery (p < 0.001), patients who received radiation therapy had longer OS than those who did not receive RT (p < 0.001), and patients who received chemotherapy had longer OS than those who did not receive chemotherapy (p < 0.001). A multivariate Cox analysis for OS showed that distant stage (HR, 3.334, 95% CI 1.544-7.199; p < 0.01) was independent prognostic factors for gastric ASC. Conclusions: Analysis of its outcomes indicates that gastric ASC is not a more malignant tumor as previously suspected. Gastric ASC shows a similar prognosis to typical gastric AC. Surgery, RT, and chemotherapy was associated with prolonged OS. Distant stage was associated with poor OS.

scholarly journals Sublobar resection is associated with decreased survival for patients with early stage large-cell neuroendocrine carcinoma of the lung

2019 ◽  
Vol 29 (4) ◽  
pp. 517-524 ◽  
Author(s):  
Waseem Lutfi ◽  
Matthew J Schuchert ◽  
Rajeev Dhupar ◽  
Inderpal Sarkaria ◽  
Neil A Christie ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Carcinoma ◽  
Early Stage ◽  
Large Cell ◽  
Sublobar Resection ◽  
Overall Survival Rate ◽  
Kaplan Meier

Abstract OBJECTIVES Sublobar resection (SLR) for early non-small-cell lung carcinoma (NSCLC) has been shown to have a survival rate similar to that of lobectomy. Large-cell neuroendocrine carcinoma (LCNEC) of the lung, although treated like an NSCLC, has a poor prognosis compared to NSCLC. We sought to determine if outcomes are poor in patients with early stage LCNEC treated with SLR versus lobectomy. METHODS We searched for patients with pathological stage I LCNEC ≤3 cm within the National Cancer Database between 2004 and 2014. Propensity score matching was used to compare the 5-year overall survival rate of patients having SLR (wedge or segmentectomy) to that of patients having a lobectomy. Patients were matched for age, node sampling, comorbidity score, tumour size, insurance status and other factors. Patients who received neoadjuvant therapy were excluded. Kaplan–Meier methods were used for analysis. RESULTS A total of 1011 patients met the inclusion criteria: 263 were treated with SLR (223 wedges and 40 segmentectomies) and 748 patients, with lobectomy. Patients who received SLR were older, had more comorbidities and smaller tumours. On unadjusted Kaplan–Meier analysis, patients who had SLR had decreased 5-year overall survival compared to those who had a lobectomy (37.9% vs 56.6%, P < 0.001). Propensity score matching (1:1) across 12 demographic and tumour variables yielded 185 patients per group with 34 segmentectomies and 151 wedge resections in the SLR cohort. On Kaplan–Meier analysis of the matched cohort, patients who had SLR had a worse 5-year overall survival rate compared to those who had a lobectomy (41.5% vs 60.3%; P = 0.001). CONCLUSIONS SLR for early stage LCNEC is associated with a lower 5-year overall survival rate compared to lobectomy on unadjusted and propensity matched analyses.

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