10-year Overall Survival For Patients Research Articles

Stage-adapted treatment of HIV-associated Hodgkin lymphoma: Long-term results of a prospective, multicenter study.

Results of a prospective study of stage-adapted treatment of humanimmunodeficiency virus (HIV)-associated Hodgkin lymphoma (HIV-HL) showed a 2-year overall survival (OS) of 90.7% with no significant difference between early favorable (EF), early unfavorable (EU), and advanced HL. Patients with EF HIV-HL received two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) + 30 Gy involved field (IF) radiation, those with EU HIV-HL received four cycles of ABVD or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) baseline + 30 Gy IF, and six to eight cycles of BEACOPP baseline were administered in advanced disease. The objective of the present analysis is to determine long-term outcomes of HIV-HL. Of 108 patients, 23 (21%) had EF HL, 14 (13%) had EU HL, and 71 (66%) had advanced-stage HL. After a median follow-up of 9.14 (range, 0-12.9) years, there were five primary refractory HL patients (5%) and 11 relapses (10%), of which seven were late relapses (>2 years). A second primary malignancy (SPM) occurred in 10 patients after a median of 7.3 years (range, 1.5-10.7) from HL diagnosis. The 10-year OS for patients with EF, EU, and advanced HL was 95.7%, 84.6%, and 76.1%, respectively. By multivariate analysis, Center for Disease Control and Prevention category C (hazard ratio [HR]3.00, 95% confidence interval [CI]:1.16-7.74, p = 0.023) and achievement of complete remission were significant for OS (HR 0.03, 95% CI: 0.01-0.08, p = 2.45 × 10-9). In conclusion, a stage-adapted treatment approach for HIV-HL is highly effective with long-term survival rates similar to those reported in HIV-uninfected HL. However, the risk for late relapse and SPM is significant.

The Outcome of Patients with Leukemia Presenting with Hyperleukocytosis Requiring Leukapheresis. The Experience of King Fahad Specialist Hospital in Dammam, Saudi Arabia

Background: Patients with acute and chronic leukemia presenting with hyperleukocytosis are at risk of developing leukostasis which has serious and life-threatening complications. Leukapheresis is usually performed to reduce the complications of leukostasis in patients presenting with hyperleukocytosis and clinical manifestations compatible with leukostasis. Methods and materials: A retrospective study of patients with acute and chronic leukemia who received leukapheresis for hyperleukocytosis between the 1st of January 2013 and the 31st of December 2023 at King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia was performed. Results: Over a period of 11 years, a total of 50 patients with acute and chronic leukemia presenting with hyperleukocytosis and clinical manifestations of leukostasis; 32 patients with acute leukemia (AL) and 18 patients with chronic myeloid leukemia (CML); received leukapheresis at our institution. Among the 32 patients with AL who received leukapheresis, 24 patients (75%) had acute myeloid leukemia (AML), 7 patients (21.88%) had acute lymphoblastic leukemia (ALL) and 1 patient (3.13%) had bilineage acute leukemia (BAL). At presentation of their AL: 3 patients (9.38%) had fever, 9 patients (28.13%) had infections, 4 patients (12.5%) had palpable spleen or liver, 6 patients (18.75%) had palpable external lymph nodes, and 9 patients (28.13%) had extramedullary disease (EMD). After receiving induction and consolidation cycles of chemotherapy, 11 patients (34.38%) of AL patients received allogeneic hematopoietic stem cell transplantation (HSCT). At the end of the follow-up, 17 patients (53.1%) with AL were alive while 15 patients (46.9%) were dead. The 8-year overall survival (OS) for all patients with AL subjected to leukapheresis was 47%. The 5 years OS for patients with AL who subsequently received HSCT and those who did not receive allogeneic HSCT were 70% and 40% respectively. The mean white blood cell (WBC) count of CML patients subjected to leukapheresis was 465.5 × 109/L, 11 patients (61.11%) had clear signs of leukostasis, and 8 patients (44.44%) had splenomegaly at presentation. Regarding the disease stage at presentation, 14 CML patients (77.78%) had chronic phase (CP), 2 patients (11.11%) had accelerated phase (AP) and 2 patients (11.11%) had blast phase (BP). Regarding the fate of CML patients at the end of the study were: 15 (83.33%) were alive, 1 (5.56%) dead, and 2 (11.11%) were unknown as they lost follow-up. However, the 10-year OS of patients with CML subjected to leukapheresis was 90%. Conclusion: Patients with acute or chronic leukemia presenting with hyperleukocytosis and either ongoing or impending leukostasis should have urgent cytoreductive chemotherapy and leukapheresis to prevent life-threatening complications. Although the outcome of AL patients presenting with leukostasis is generally poor, prompt cytoreductive therapy and leukapheresis, followed by induction chemotherapy and allogeneic HSCT may improve the outcome. Also, urgent cytoreduction including leukapheresis improves the outcome of patients with CML presenting with hyperleukocytosis and leukostasis.

Отдаленные результаты лечения пациентов с классической лимфомой Ходжкина в реальной клинической практике: опыт гематологического отделения Новосибирска

Aim. To assess the long-term results of classical Hodgkin’s lymphoma (cHL) treatment in Novosibirsk in real-world clinical practice.
 Materials & Methods. The study enrolled 408 cHL patients treated and followed-up at the hematological unit of the Novosibirsk Municipal Clinical Hospital No. 2 from January 2008 to December 2021. The median age of patients was 33 years (range 26–44 years). Among them 223 (54.7 %) female and 185 (45.3 %) male patients. There were more patients with cHL stages III (n = 103; 25.2 %) and IV (n = 120; 29.4 %) than with stage II, which was identified in 185 (45.4 %) patients. ABVD regimen was administered to 132 (32.3 %) patients, 47 (11.5 %) patients received ABVD escalated to BEACOPP. BEACOPP therapy was performed in 229 (56.2 %) patients. Subsequent radiotherapy was assigned to 202 (49.5 %) patients. Second-line therapy was required by 89 (21.8 %) patients with relapsed and resistant cHL.
 Results. The 10-year overall survival (OS) was 81 %, and the 5-year OS was 91 %. Similar progression-free survival (PFS) rates were 86 % and 77 %, respectively. The 10-year PFS in patients with stage II was 87 %, while in patients with stages II (mediastinal bulky mass), III and IV, it was only 69 % (p = 0.002). The 10-year OS in patients with localized stages was 91 %, and in patients with generalized stages it was 79 % (p = 0.0006). The 10-year OS in patients less than 45 years of age was 88 %, and in patients more than 45 years of age it was 69 %. The 10-year PFS in patients less than 45 years of age was 84 %, and in the older age group it was 60 % (p = 0.001).
 Conclusion. The study results demonstrate high rates of long-term survival of cHL patients and are well comparable with the data of other study groups. Nevertheless, scientific research should be continued to develop optimal risk-adapted programs of cHL chemotherapy and to define further prospects for improving the treatment outcomes of this malignant tumor.

Survival after resection of malignant peripheral nerve sheath tumors: Introducing and validating a novel type-specific prognostic model.

This study aimed to assess the performance of currently available risk calculators in a cohort of patients with malignant peripheral nerve sheath tumors (MPNST) and to create an MPNST-specific prognostic model including type-specific predictors for overall survival (OS). This is a retrospective multicenter cohort study of patients with MPNST from 11 secondary or tertiary centers in The Netherlands, Italy and the United States of America. All patients diagnosed with primary MPNST who underwent macroscopically complete surgical resection from 2000 to 2019 were included in this study. A multivariable Cox proportional hazard model for OS was estimated with prespecified predictors (age, grade, size, NF-1 status, triton status, depth, tumor location, and surgical margin). Model performance was assessed for the Sarculator and PERSARC calculators by examining discrimination (C-index) and calibration (calibration plots and observed-expected statistic; O/E-statistic). Internal-external cross-validation by different regions was performed to evaluate the generalizability of the model. A total of 507 patients with primary MPNSTs were included from 11 centers in 7 regions. During follow-up (median 8.7 years), 211 patients died. The C-index was 0.60 (95% CI 0.53-0.67) for both Sarculator and PERSARC. The MPNST-specific model had a pooled C-index of 0.69 (95%CI 0.65-0.73) at validation, with adequate discrimination and calibration across regions. The MPNST-specific MONACO model can be used to predict 3-, 5-, and 10-year OS in patients with primary MPNST who underwent macroscopically complete surgical resection. Further validation may refine the model to inform patients and physicians on prognosis and support them in shared decision-making.

Long-Term Survival Analysis and Prognostic Factors of Arabic Patients with Differentiated Thyroid Carcinoma: A 20-Year Observational Study at the King Hussein Cancer Center (KHCC) Involving 528 Patients.

DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan-Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center's (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.

Efficacy of concurrent chemoradiotherapy alone for loco-regionally advanced nasopharyngeal carcinoma: long-term follow-up analysis

BackgroundTo analysis the clinical outcomes of concurrent chemoradiotherapy (CCRT) alone based on 10-year results for loco-regionally advanced nasopharyngeal carcinoma (LANPC), so as to provide evidence for individualized treatment strategy and designing appropriate clinical trial for different risk LANPC patients.MethodsConsecutive patients with stage III-IVa (AJCC/UICC 8th) were enrolled in this study. All patients received radical intensity-modulated radiotherapy (IMRT) and concurrent cisplatin chemotherapy (CDDP). The hazard ratios (HRs) of death risk in patients with T3N0 was used as baseline, relative HRs were calculated by a Cox proportional hazard model to classify different death risk patients. Survival curves for the time-to-event endpoints were analyzed by the Kaplan–Meier method and compared using the log-rank test. All statistical tests were conducted at a two-sided level of significance of 0.05.ResultsA total of 456 eligible patients were included. With 12-year median follow-up, 10-year overall survival (OS) was 76%. 10-year loco-regionally failure-free survival (LR-FFS), distant failure-free survival (D-FFS) and failure-free survival (FFS) were 72%, 73% and 70%, respectively. Based on the relative hazard ratios (HRs) of death risk, LANPC patients were classified into 3 subgroups, low-risk group (T1-2N2 and T3N0-1) contained 244 patients with HR < 2; medium-risk group (T3N2 and T4N0-1) contained 140 patients with HR of 2 – 5; high-risk group (T4N2 and T1-4N3) contained 72 patients with HR > 5. The 10-year OS for patients in low-, medium-, and high-risk group were 86%, 71% and 52%, respectively. Significantly differences of OS rates were found between each of the two groups (low-risk group vs. medium-risk group, P < 0.001; low-risk group vs. high-risk group, P < 0.001; and medium-risk group vs. high-risk group, P = 0.002, respectively). Grade 3–4 late toxicities included deafness/otitis (9%), xerostomia (4%), temporal lobe injury (5%), cranial neuropathy (4%), peripheral neuropathy (2%), soft tissue damage (2%) and trismus (1%).ConclusionsOur classification criteria demonstrated that significant heterogeneity in death risk among TN substages for LANPC patients. IMRT plus CDDP alone maybe suitable for low-risk LANPC (T1-2N2 or T3N0-1), but not for medium- and high-risk patients. These prognostic groupings provide a practicable anatomic foundation to guide individualized treatment and select optimal targeting in the future clinical trials.

Expression Levels of GHRH-Receptor, pAkt and Hsp90 Predict 10-Year Overall Survival in Patients with Locally Advanced Rectal Cancer

Rectal cancer constitutes nearly one-third of all colorectal cancer diagnoses, and certain clinical and molecular markers have been studied as potential prognosticators of patient survival. The main objective of our study was to investigate the relationship between the expression intensities of certain proteins, including growth-hormone-releasing hormone receptor (GHRH-R), Hsp90, Hsp16.2, p-Akt and SOUL, in specimens of locally advanced rectal cancer patients, as well as the time to metastasis and 10-year overall survival (OS) rates. We also investigated whether these outcome measures were associated with the presence of other clinical parameters. In total, 109 patients were investigated retrospectively. Samples of pretreatment tumors were stained for the proteins GHRH-R, Hsp90, Hsp16.2, p-Akt and SOUL using immunhistochemistry methods. Kaplan-Meier curves were used to show the relationships between the intensity of expression of biomarkers, clinical parameters, the time to metastasis and the 10-year OS rate. High levels of p-Akt, GHRH-R and Hsp90 were associated with a significantly decreased 10-year OS rate (p = 0.001, p = 0.000, p = 0.004, respectively) and high expression levels of p-Akt and GHRH-R were correlated with a significantly shorter time to metastasis. Tumors localized in the lower third of the rectum were linked to both a significantly longer time to metastasis and an improved 10-year OS rate. Hsp 90, pAkt and GHRH-R as well as the lower-third localization of the tumor were predictive of the 10-year OS rate in locally advanced rectal cancer patients. The GHRH-R and Hsp90 expression levels were independent prognosticators of OS. Our results imply that GHRH-R could play a particularly important role both as a molecular biomarker and as a target for the anticancer treatment of advanced rectal cancer.

Expression Levels of GHRH-Receptor, pAkt and Hsp90 Predict 10-Year Overall Survival in Patients with Locally Advanced Rectal Cancer

Rectal cancer constitutes nearly one-third of all colorectal cancer diagnoses and certain clinical and molecular markers have been studied as potential prognosticators of patient survival. The main objective of our study was to investigate the relationship between the expression intensities of certain proteins

Establishment and validation of an individualized nomogram for survival prediction of primary mediastinal germ cell tumors based on the SEER database.

BackgroundPrimary mediastinal germ cell tumors (PMGCT) represent a rare but sometimes highly aggressive type of mediastinal tumors. The current prognostic models for PMGCT are insufficient. This study was undertaken to establish and validate an individualized nomogram for predicting the overall survival (OS) of patients with PMGCT.MethodsWe conducted a retrospective analysis of patients with PMGCT diagnosed between 2000 and 2018 in the Surveillance, Epidemiology, and End Results (SEER) database in the United States. Clinical variables included surgery subtype, gender, treatment regimens, age, histology, tumor size, stage, chemotherapy, radiation, race, and survival-related information. The main outcome measure was survival duration. The Kaplan-Meier method along with the log-rank test were utilized to estimate the OS. Independent prognostic factors were identified by performing the univariate and multivariate Cox proportional hazards regression analyses, from which an individualized nomogram was constructed to predict 3-, 5-, and 10-year OS of patients with PMGCT. The concordance index (C-index) and calibration curve were used to verify the discrimination and accuracy of the nomogram.ResultsA total of 845 patients with PMGCT were recruited from the SEER database and further randomly assigned to a training set (n=635) and a validation set (n=210) at a ratio of 7:3. The 3-, 5-, and 10-year OS for overall PMGCT was 70.0%, 67.1%, and 63.9%, respectively. Cox regression analysis indicated that age, tumor size, stage, chemotherapy, radiation, histology, and surgery type were as independent factors for OS in patients with PMGCT (P<0.05). An individualized nomogram for OS was constructed utilizing these variables, with the C-index of 0.714 [95% confidence interval (CI): 0.695 to 0.743] and 0.756 (95% CI: 0.735 to 0.787) in the training and validation groups. Moreover, good levels of agreement were observed according to the calibration curve between the predicted and actual 3-, 5-, and 10-year survival rates both in the training and validated cohorts, showing that the model could accurately predict patient prognosis.ConclusionsThis study documented the first attempt at establishing and validating a novel nomogram for predicting the 3-, 5-, and 10-year OS probabilities of PMGCT. The prognostic nomogram was demonstrated to have good performance for predicting individualized OS of patients with PMGCT.

Ten-year survival for patients with epithelial ovarian cancer treated with consolidation hyperthermic intraperitoneal chemotherapy (331)

<b>Objectives:</b> We aimed to evaluate the long-term efficacy of consolidation hyperthermic intraperitoneal chemotherapy (HIPEC) for patients with epithelial ovarian cancer. <b>Methods:</b> This retrospective study included patients who received consolidation HIPEC at Seoul St. Mary's Hospital between January 1991 and December 2003. Consolidation HIPEC was performed during the second-look operation for patients who had a complete or partial response after primary cytoreductive surgery (CRS) and adjuvant platinum-based chemotherapy. HIPEC was performed by perfusion of 6L of lactated Ringer's solution and paclitaxel 175 mg/m² or carboplatin 350 mg/m² at 43-44°C for 90 minutes. Ten-year progression-free survival (PFS) and overall survival (OS) were analyzed and compared with patients who underwent second-look operation without HIPEC. <b>Results:</b> A total of 87 patients were included. Of these, 44 patients (50.6%) received consolidation HIPEC, and the other 43 (49.4%) received second-look operation only (No HIPEC). The 10-year PFS rate was significantly longer in the HIPEC group compared to the control group (59.1% vs 34.9%, p=0.032), and there was a marginal significance in the 10-year OS rate between the two groups (59.1% vs 37.2%, p=0.054). In a subgroup of patients with stage III, HIPEC group showed significantly longer 10-year PFS and OS rate compared with the control group (PFS: 53.8% vs 14.8%, p=0.001; OS: 38.5% vs 11.1%, p=0.036). Multivariate analysis identified HIPEC as an independent favorable prognostic factor for the 10-year PFS (adjusted HR: 0.49, 95% CI: 0.25-0.96, p=0.039), although not for the 10-year OS (adjusted HR: 0.60, 95% CI: 0.31-1.17, p=0.133). Patients who underwent HIPEC with paclitaxel showed a trend of higher PFS and OS compared with those who underwent HIPEC with carboplatin, although the result was not statistically significant (PFS: adjusted HR: 0.39, 95% CI: 0.13-1.2, p=0.102; OS: adjusted HR: 0.31, 95% CI: 0.03-1.1, p=0.070). Adverse events more common in the HIPEC group included thrombocytopenia, elevated liver enzyme, and wound complications. However, these adverse events were reversible and did not delay subsequent consolidation chemotherapy. <b>Conclusions:</b> The consolidation HIPEC demonstrated a significant improvement in 10-year PFS and a marginally significant improvement in 10-year OS in patients with epithelial ovarian cancer, with acceptable toxicity. Fig. 1

Mid and long-term overall survival after carcinologic resections of thyroid cancer bone metastases.

BackgroundBone metastases in thyroid cancer impair the patient's quality of life and prognosis. Interestingly, wide margins resection as the surgical treatment of bone metastases might improve the overall survival (OS). Nonetheless, data are lacking regarding the potential benefits of this strategy.MethodsIn order to assess the OS of patients with thyroid cancer after a bone metastases carcinologic resection, a retrospective multicentric study was performed, evaluating the 1, 5, 10 and 15 years-OS along with the potential prognosis associated factors.Results40 patients have been included in this multicentric study, with a mean follow-up after surgery of 46.6 ± 58 months. We observed 25 (62.5%) unimestastatic patients and 15 multimetastatic patients (37.5%). The median overall survival after resection was 48 ± 57.3 months. OS at 1, 5, 10, and 15 years was respectively 76.2%, 63.6%, 63.6%, and 31.8%. Survival for patients with a single bone metastasis at 15 year was 82.3%, compared with 0.0% (Log Rank, p = 0.022) for multi-metastatic bone patients.ConclusionsThis study advocates for an increased long term 10-year OS in patients with thyroid cancer, after resection of a single bone metastasis, suggesting the benefits of this strategy in this population.

Survival of BRCA1/BRCA2-associated pT1 breast cancer patients, a cohort study

PurposeIntensive screening in BRCA1/2 mutation carriers aims to improve breast cancer (BC) prognosis. Our aim is to clarify the prognostic impact of tumor size in BRCA mutation carriers with a pT1 BC, which is currently unclear. We are especially interested in differences between pT1a, pT1b, and pT1c regarding the prognosis of node-negative breast cancer, the effect of chemotherapy, and the prevalence of lymph node involvement.MethodsFor this study, BRCA1/2-associated BC patients were selected from a nationwide cohort. Primary outcomes were 10-year overall survival (OS) per pT1a-b-c group and the effect of chemotherapy on prognosis of node-negative BC, using Kaplan–Meier and Cox models. Finally, we evaluated lymph node involvement per pT1a-b-c group.Results963 women with pT1 BRCA1/2-associated BC diagnosed between 1990 and 2017 were included, of which 679 had pN0 BC. After a median follow-up of 10.5 years, 10-year OS in patients without chemotherapy was 77.1% in pT1cN0 and lower than for pT1aN0 (91.4%, p = 0.119) and pT1bN0 (90.8%, p = 0.024). OS was better with than without chemotherapy for pT1cN0 (91.6% vs. 77.1%, p = 0.001; hazard ratio (HR) 0.56, 95% confidence interval (CI): 0.21–1.48). Lymph node involvement was 24.9% in pT1c, 18.8% in pT1b, and 8.6% in pT1a.ConclusionSmaller tumor size is associated with better OS and less lymph node involvement in pT1 BRCA1/2-associated BC patients. The results suggest that early detection in BRCA1/2 mutation carriers of pT1a/b BC may reduce mortality and the need for systemic therapy.

Overall survival is improved with total thyroidectomy and radiation for male patients and patients older than 55 with T2N0M0 Stage 1 classic papillary thyroid cancer

BackgroundWe examine whether surgery extent and radiation administration affect overall survival for cT2N0M0 classic papillary thyroid cancer according to age and sex. MethodsPatients with cT2N0M0 classic papillary thyroid cancer tumors in the National Cancer Data Base (2004−2016) were selected. Multivariable Cox regression analysis compared patients (combined male + female cohorts) having lobectomy to those having total thyroidectomy with or without radiation (primarily radioactive iodine) for ages: 18 to 45, 46 to 55, and >55 years. In addition, 1:1 propensity score matching and Kaplan-Meier curves with 10-year overall survival estimates, and log-rank test were stratified by age and sex. ResultsLobectomy had equivalent overall survival to total thyroidectomy without and with radiation for patients (combined male + female cohorts) aged 18 to 45 and 46 to 55 years on multivariable analysis. On propensity score matching there was overall survival advantage for total thyroidectomy with radiation over both lobectomy and total thyroidectomy for men (ages 18−90+ combined) and overall survival advantage in patients (combined male + female cohort) aged >55 years having total thyroidectomy with radiation versus lobectomy. On propensity score matching there were no overall survival differences in women (ages 18–90+ combined) or patients (combined male + female cohort) aged 18 to 45 and 46 to 55 years having either lobectomy, total thyroidectomy, or total thyroidectomy with radiation. ConclusionFor cT2N0M0 classic papillary thyroid cancer, total thyroidectomy with radiation improves 10-year overall survival for patients (combined male + female cohort) aged >55 years and men (ages 18–90+ combined).

Abstract PS8-07: Predictors of 10-year overall survival in patients with breast cancer

Abstract Background: The combination of mass screening programs and improved, targeted therapies have led to a substantial increase in the number of breast cancer (BC) survivors. Despite a growing majority of patients surviving beyond 5 years, few studies have examined prognostic factors associated with 10-year overall survival (OS) in breast cancer. Methods: We conducted a retrospective analysis of patients with BC using the National Cancer Database (NCDB). Our dataset documents survival leading up to and including the year 2016. Thus, to evaluate factors associated with 10-year OS, we included patients diagnosed between 2004-2006. We described sociodemographic and clinicopathologic characteristics of this cohort using frequencies/percentages. Variables were included in a multiple logistic regression model predicting 10-year OS, and considered statistically significant to a p-value &amp;lt;0.001, due to the large sample size. Results: A total of n=515,610 patients with BC were analyzed. The age distribution included n=125,657 (24.4%) &amp;lt;50 years, n=256,003 (49.7%) between 50-70 years, and n=133,950 (26.0%) &amp;gt;70 years. N=440,048 (87.6%) were White, n=52,220 (10.4%) were Black, and n=9872 (2.0%) were Asian. 10-year OS by AJCC clinical stage was: 54.5% for patients diagnosed at stage 0, 50.0% at stage I, 42.4% at stage II, 29.7% at stage III, and 6.1% at stage IV. Sociodemographic variables significantly associated with 10-year OS were: age, race, income, insurance status, and facility type (Table 1). Black patients were less likely to exhibit 10-year OS compared to White patients (40.7% compared to 48.0%, OR 0.821, 95% CI 0.786-0.858, p&amp;lt;0.001). Patients with an estimated annual income &amp;gt;$46,000 were more likely to experience 10-year OS compared to those with an annual income &amp;lt;$30,000 (50.5% compared to 41.8%, OR 1.126, 95% CI 1.076-1.178, p&amp;lt;0.001). Compared to patients treated at community cancer programs (CPs), those treated at comprehensive community CPs were more likely to experience long-term survival (47.7% versus 43.8%, OR 1.125, 95% CI 1.077-1.175, p&amp;lt;0.001). Clinicopathologic factors significantly associated with 10-year OS were: Charlson/Deyo comorbidity index, AJCC clinical staging, tumor grade, estrogen receptor (ER) status, progesterone receptor (PR) status, the use of surgery, radiation, chemotherapy, hormonal therapy, and immunotherapy (Table 1). Compared to patients with well-differentiated tumors, those with moderately-differentiated (OR 0.889, 95% CI 0.860-0.919, p&amp;lt;0.001) and poorly-differentiated tumors (OR 0.782, 95% CI 752-0.812, p&amp;lt;0.001) had lower long-term survival. ER positivity was associated with a lower likelihood of 10-year OS, while PR positivity was associated with a higher likelihood of 10-year OS. However, effect sizes for receptor status are small (ORs between 0.90-1.10), and thus may not have clinical relevance despite statistical significance. HER2 status was not documented in the NCDB before 2010, so its prognostic value could not be evaluated. Tumor histology was not significantly associated with 10-year OS. Conclusions: 10-year OS data for BC is scarce. We found high rates of 10-year OS, particularly in patients diagnosed at early stages. This is welcomed news; emphasizing the real-world impact of population screening. As anticipated, racial disparities and social determinants of health remain relevant prognosticators of long-term survival. Table 1: Multiple logistic regression model predicting 10-year OS in patients with breast cancer.VariableNo. (%)10-year OS%OR95% CIp-valueAge&amp;lt;.001&amp;lt;50 (ref)125,657 (24.4%)54.1%1.000---50-70256,003 (49.7%)53.0%.946.916.978.001&amp;gt;70133,950 (26.0%)30.1%.427.407.448&amp;lt;.001Race&amp;lt;.001White (ref)440,048 (87.6%)48.0%1.000---Black52,220 (10.4%)40.7%.821.786.858&amp;lt;.001Asian9872 (2.0%)51.9%1.1661.0671.275.001EthnicityHispanic (ref)445,220 (95.6%)47.7%1.000---Non-Hispanic20,481 (4.4%)44.4%.936.878.998.042Income&amp;lt;.001&amp;lt;$30,000 (ref)55,038 (11.0%)41.8%1.000---$30,000-$34,99979,054 (15.8%)44.9%1.026.9771.078.296$35,000-$45,999133,171 (26.6%)46.7%1.0651.0171.115.008&amp;gt;$46,000233,078 (46.6%)50.5%1.1261.0761.178&amp;lt;.001Insurance status&amp;lt;.001Uninsured (ref)10,440 (2.1%)36.8%1.000---Private insurance284,063 (56.5%)55.4%1.5521.4171.701&amp;lt;.001Medicare181,088 (36.0%)36.5%1.2641.1501.390&amp;lt;.001Medicaid/other governmental insurance26,766 (5.3%)41.8%1.2111.0921.343&amp;lt;.001Facility type&amp;lt;.001Community cancer program (ref)46,176 (9.4%)43.8%1.000---Comprehensive community cancer program227,815 (46.5%)47.7%1.1251.0771.175&amp;lt;.001Academic/research program142,123 (29.0%)49.0%1.0631.0151.113.010Integrated network cancer program73,703 (15.0%)44.6%.819.776.865&amp;lt;.001Setting.001Metro (ref)427,832 (85.6%)47.6%1.000---Urban63,288 (12.7%)47.4%1.0761.0341.120&amp;lt;.001Rural8534 (1.7%)47.4%1.091.9841.209.099Charlson/Deyo comorbidity index.0000 (ref)450,329 (87.3%)49.1%1.000---152,983 (10.3%)38.3%.746.717.777&amp;lt;.00129425 (1.8%)25.1%.506.459.557&amp;lt;.00132873 (0.6%)16.4%.343.280.421&amp;lt;.001AJCC clinical staging&amp;lt;.0010 (ref)59,736 (25.7%)54.5%1.000---187,698 (37.7%)50.0%.731.703.760&amp;lt;.001251,604 (22.2%)42.4%.526.503.551&amp;lt;.001318,871 (8.1%)29.7%.281.264.299&amp;lt;.001414,620 (6.3%)6.1%.073.065.082&amp;lt;.001Grade&amp;lt;.001Well-differentiated (ref)94,046 (21.2%)51.6%1.000---Moderately-differentiated184,976 (41.7%)48.5%.889.860.919&amp;lt;.001Poorly differentiated164,490 (37.1%)44.9%.782.752.812&amp;lt;.001Histology.007Ductal carcinoma (ref)367,409 (72.7%)47.7%1.000---Lobular carcinoma79,387 (15.7%)47.3%.993.9571.031.720Other carcinoma47,959 (9.5%)49.1%1.013.9661.061.598Epithelial-myoepithelial1861 (0.4%)42.1%.898.7031.146.385Papillary6005 (1.2%)30.8%1.054.8831.260.559Fibroepithelial2058 (0.4%)34.9%.937.7551.162.552Mesenchymal402 (0.1%)21.4%.7130.3091.645427Estrogen receptor statusNegative (ref)97,628 (21.9%)43.9%1.000---Positive348,611 (78.1%)48.6%.908.868.949&amp;lt;.001Progesterone receptor statusNegative (ref)147,951 (33.6%)44.0%1.000---Positive292,529 (66.4%)49.3%1.0951.0571.134&amp;lt;.001Type of surgery.000None (ref)30,799 (6.0%)15.8%1.000---Lumpectomy294,554 (57.3%)52.6%2.3002.1122.506&amp;lt;.001Mastectomy188,531 (36.7%)44.3%2.3202.1342.523&amp;lt;.001RadiationNo (ref)239,355 (47.5%)40.4%1.000---Yes264,681 (52.5%)53.3%1.3851.3411.430&amp;lt;.001ChemotherapyNo (ref)309,000 (62.9%)46.0%1.000---Yes182,510 (37.1%)49.2%1.3751.3311.420&amp;lt;.001Hormonal therapyNo (ref)245,859 (51.0%)42.3%1.000---Yes236,454 (49.0%)51.9%1.2071.1671.248&amp;lt;.001ImmunotherapyNo (ref)497,793 (99.6%)47.2%1.000---Yes1862 (0.4%)43.3%1.2731.2361.311&amp;lt;.001 Citation Format: Nadeem Bilani, Leah Elson, Hong Liang, Elizabeth Elimimian, Zeina Nahleh. Predictors of 10-year overall survival in patients with breast cancer [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-07.

Durable benefit of rituximab maintenance post-autograft in patients with relapsed follicular lymphoma: 12-year follow-up of the EBMT lymphoma working party Lym1 trial.

We report the 12-year follow-up of the prospective randomized EBMT LYM1 trial to determine whether the benefit of brief duration rituximab maintenance (RM) on progression-free survival (PFS) in patients with relapsed follicular lymphoma (FL) receiving an autologous stem cell transplant (ASCT) is sustained. One hundred and thirty-eight patients received RM with or without purging. The median follow-up after random assignment is 12 years (range 10-13) for the whole series. The 10-year PFS after ASCT is 47% (95% CI 40-54) with only 4 patients relapsing after 7.5 years. RM continues to significantly improve 10-year PFS after ASCT in comparison with NM [P = 0.002; HR 0.548 (95% CI 0.38-0.80)]. Ten-year non-relapse mortality (NRM) was not significantly different between treatment groups (7% overall). 10-year overall survival (OS) after ASCT was 75% (69-81) for the whole series, with no significant differences according to treatment sub-groups. 10-year OS for patients who progressed within 24 months (POD24T) was 60%, in comparison with 85% for patients without progression. Thus the benefit of rituximab maintenance after ASCT on relapse prevention is sustained at 12 years, suggesting that RM adds to ASCT-mediated disease eradication and may enhance the curative potential of ASCT.

The Extracompartmental Tumoral Invasion of Extraskeletal Myxoid Chondrosarcoma Induces Distant Metastasis.

Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant soft-tissue tumor and often shows extracompartmental tumoral invasion. The aim of our study was to investigate the clinical features, especially extracompartmental tumoral invasion (ETI) of EMC. A total of 35 operative patients diagnosed with EMC were enrolled in this study from January 1980 to March 2018 in the Cancer Institute Hospital of The Japanese Foundation for Cancer Research. The operative procedure was principally wide excision. Univariate analysis assessed how clinicopathological factors (e.g. age, gender, tumor site, tumor size, histopathological grade, surgical margin, metastasis before operation, barrier invasion, local recurrence, metastasis after operation) influenced patient prognosis. We assessed how clinicopathological factors influenced ETI of EMC. Among 35 patients, 10 patients showed ETI. The average follow-up was 5.57 (range=0.2-20 years). The 5- and 10-year overall survival was 91.3% and 71.2%, respectively. The 5- and 10-year overall survival of patients with M0 disease was 96.1% and 73.2%, respectively, while both were 75.0% for those with M1 disease, respectively. The patients with distant metastasis at first visit tended to have a poor prognosis (p=0.07). It is notable that all of the 10 patients with ETI had distant metastasis after surgery. Patients with distant metastasis at first visit tended to have a poor prognosis. ETI of EMC induced distant metastasis after surgery. Patients with ETI of EMC should, therefore, be carefully monitored over a prolonged period.

Prediction of 10-year Overall Survival in Patients with Operable Cervical Cancer using a Probabilistic Neural Network.

Background: Toward the goal of predicting individual long-term cancer survival to guide treatment decisions, this study evaluated the ability of a probabilistic neural network (PNN), an established model used for decision-making in research and clinical settings, to predict the 10-year overall survival in patients with cervical cancer who underwent primary surgical treatment.Patients and Method: The input dataset was derived from 102 patients with cervical cancer FIGO stage IA2-IIB treated by radical hysterectomy. We identified 4 demographic parameters, 13 tumor-related parameters, and 6 selected perioperative variables for each patient and performed computer simulations with DTREG software. The predictive ability of the model was determined on the basis of its error, sensitivity, and specificity, as well as area under the receiver operating characteristic curve. The results of the PNN predictive model were compared with those of logistic regression analysis and a single decision tree as reference models.Results: The PNN model had very high predictive ability, with a sensitivity of 0.949, a specificity of 0.679, and an error rate of 12.5%. The PNN's area under the receiver operating characteristic curve was high, 0.809, a value greater than those for both logistic regression analysis and the single decision tree.Conclusion: The PNN model effectively and reliably predicted 10-year overall survival in women with operable cervical cancer, and may therefore serve as a tool for decision-making process in cancer treatment.

Impact of MYD88L265P mutation Status on Histological Transformation of Waldenstrom Macroglobulinemia

Impact of MYD88L265P mutation Status on Histological Transformation of Waldenstrom Macroglobulinemia

Long-term survival after R0 resection of thymoma

Background The aim of this study was to evaluate the results of R0 resection of thymoma to identify prognostic factors for long-term outcomes. Methods Data of 62 patients (28 male, 34 female) with a mean age of 47.26 ± 14.42 years, who underwent R0 resection for thymoma and were followed-up between February 2004 and March 2016, were analyzed retrospectively. Results Eight patients had a video-assisted thoracoscopic thymectomy and 54 had a transsternal extended thymectomy. During a mean follow-up of 128.67 ± 7.95 months, regional recurrence of thymoma was observed in 9 (14.5%) patients. Overall 5- and 10-year survival rates were 85.36% and 78.20%, respectively. The 5- and 10-year survival rates in patients aged < 50 years were significantly better than in those aged ≥ 50 years (92% and 72% vs. 88% and 39%, p < 0.0001). The 10-year overall survival of patients in Masaoka stage I and II was better than those in stage III (88.9%, 78.4%, 69.8%, respectively, log-rank p < 0.001). The 10-year survival of patients with World Health Organization histological type A, AB, and B1 thymomas was better than those with type B2 and B3 (log-rank test p < 0.001). In multivariate analysis, age < 50 years ( p = 0.001), Masaoka stage ( p = 0.006), histological type ( p = 0.001), and recurrence ( p = 0.04) were independent prognostic factors for survival. Conclusion Our study indicates that age < 50 years, Masaoka stage, histological type, and recurrence are the determinants of survival in surgically resected cases of thymoma.

Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis

The results of the American College of Surgeons Oncology Group Z0011 (ACOSOG Z0011) trial were first reported in 2005 with a median follow-up of 6.3 years. Longer follow-up was necessary because the majority of the patients had estrogen receptor-positive tumors that may recur later in the disease course (the ACOSOG is now part of the Alliance for Clinical Trials in Oncology). To determine whether the 10-year overall survival of patients with sentinel lymph node metastases treated with breast-conserving therapy and sentinel lymph node dissection (SLND) alone without axillary lymph node dissection (ALND) is noninferior to that of women treated with axillary dissection. The ACOSOG Z0011 phase 3 randomized clinical trial enrolled patients from May 1999 to December 2004 at 115 sites (both academic and community medical centers). The last date of follow-up was September 29, 2015, in the ACOSOG Z0011 (Alliance) trial. Eligible patients were women with clinical T1 or T2 invasive breast cancer, no palpable axillary adenopathy, and 1 or 2 sentinel lymph nodes containing metastases. All patients had planned lumpectomy, planned tangential whole-breast irradiation, and adjuvant systemic therapy. Third-field radiation was prohibited. The primary outcome was overall survival with a noninferiority hazard ratio (HR) margin of 1.3. The secondary outcome was disease-free survival. Among 891 women who were randomized (median age, 55 years), 856 (96%) completed the trial (446 in the SLND alone group and 445 in the ALND group). At a median follow-up of 9.3 years (interquartile range, 6.93-10.34 years), the 10-year overall survival was 86.3% in the SLND alone group and 83.6% in the ALND group (HR, 0.85 [1-sided 95% CI, 0-1.16]; noninferiority P = .02). The 10-year disease-free survival was 80.2% in the SLND alone group and 78.2% in the ALND group (HR, 0.85 [95% CI, 0.62-1.17]; P = .32). Between year 5 and year 10, 1 regional recurrence was seen in the SLND alone group vs none in the ALND group. Ten-year regional recurrence did not differ significantly between the 2 groups. Among women with T1 or T2 invasive primary breast cancer, no palpable axillary adenopathy, and 1 or 2 sentinel lymph nodes containing metastases, 10-year overall survival for patients treated with sentinel lymph node dissection alone was noninferior to overall survival for those treated with axillary lymph node dissection. These findings do not support routine use of axillary lymph node dissection in this patient population based on 10-year outcomes. clinicaltrials.gov Identifier: NCT00003855.