Survival In China Research Articles

Self-employment survival in China: does family involvement matter?

Using data from the China Household Finance Survey spanning 2015–2019, we investigate the relationship between family involvement and self-employment survival. Instrumental variables are used to address the potential endogeneity of family involvement. We show that family involvement is crucial in reducing self-employment exit. This significant effect is more pronounced in elderly self-employed and self-employed with children aged 0–5. The underlying mechanisms reveal that family members’ participation in self-employment flexibly allocates idle household labor and improves the household employment rate. Meanwhile, self-employment with family involvement may have better access to credit and better performance, thus enhancing self-employment survival. Our findings are validated by robustness checks, including a discrete time complementary log–log model and estimations using alternative measurements of family involvement and self-employment exit. Our study has useful implications for policy-makers to stimulate family involvement to promote self-employment survival.

Amyotrophic lateral sclerosis patients with various gene mutations show diverse motor phenotypes and survival in China

BackgroundAmyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disorder characterised by progressive degeneration of motor neurons. Genetic factors have a substantial impact on ALS. Therefore, this study aimed to explore...

Unveiling the spatial distribution and transboundary pathways of FMD serotype O in Western China and its bordering countries.

Foot-and-mouth disease (FMD) is a severe, highly contagious viral disease of livestock that has a significant economic impact on domestic animals and threatens wildlife survival in China and border countries. However, effective surveillance and prevention of this disease is often incomplete and unattainable due to the cost, the great diversity of wildlife hosts, the changing range and dynamics, and the diversity of FMDV. In this study, we used predictive models to reveal the spread and risk of FMD in anticipation of identifying key nodes to control its spread. For the first time, the spatial distribution of FMD serotype O was predicted in western China and border countries using a niche model, which is a combination of eco-geographic, human, topographic, and vegetation variables. The transboundary least-cost pathways (LCPs) model for ungulates in the study area were also calculated. Our study indicates that FMD serotype O survival is seasonal at low altitudes (March and June) and more sensitive to temperature differences at high altitudes. FMD serotype O risk was higher in Central Asian countries and both were highly correlated with the population variables. Ten LCPs were obtained representing Pakistan, Kazakhstan, Kyrgyzstan, and China.

HR-positive/HER2-negative breast cancer arising in patients with or without BRCA2 mutation: different biological phenotype and similar prognosis.

BRCA2 plays a key role in homologous recombination. However, information regarding its mutations in Chinese patients with breast cancer remains limited. This study aimed to assess the clinicopathological characteristics of BRCA2 mutation breast cancer and explore the mutation's effect on hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer survival in China. This hospital-based cohort study prospectively included 629 women with breast cancer diagnosed from 2008 to 2023 at Zhejiang Cancer Hospital in China. We compared the clinicopathological characteristics and metastatic patterns and analysed the invasive disease-free survival (iDFS), distant relapse-free survival (DRFS) and first-line progression-free survival (PFS1) of patients with HR-positive/HER2-negative breast cancer according to BRCA2 mutations. Among the 629 patients, 78 had BRCA2 mutations (12.4%) and 551 did not (87.6%). The mean age at diagnosis was lower in the BRCA2 mutation breast cancer group than in the non-mutation breast cancer group (38.91 versus 41.94 years, p = 0.016). BRCA2 mutation breast cancers were more likely to be lymph node-positive than non-mutation breast cancers (73.0% versus 56.6%, p = 0.037). The pathological grade was higher in 47.1% of BRCA2 mutation breast cancers than in 29.6% of non-mutation breast cancers (p = 0.014). The proportions of patients with BRCA2 mutations who developed contralateral breast cancer (19.2% versus 8.8%, p = 0.004), breast cancer in the family (53.8% versus 38.3%, p = 0.009) and ovarian cancer in the family (7.6% versus 2.4%, p = 0.022) were higher than those of patients without the mutation. The median follow-up time was 92.78 months. Multivariate analysis showed that BRCA2 mutation was not associated with poorer iDFS [hazard ratio = 0.9, 95% confidence interval (CI) = 0.64-1.27, p = 0.56] and poorer distant relapse-free survival (DRFS) (hazard ratio = 1.09, 95% CI = 0.61-1.93, p = 0.76). There was no significant difference between the two groups with regard to metastatic patterns in the advanced disease setting. In the first-line metastatic breast cancer setting, PFS1 expression was broadly similar between the two groups irrespective of chemotherapy or endocrine therapy. HR-positive/HER2-negative breast cancer with BRCA2 mutations differs from those without mutations in clinical behaviour and reflects more aggressive tumour behaviour. Our results indicate that BRCA2 mutations have no significant effect on the survival of Chinese women with HR-positive/HER2-negative breast cancer.

Resuscitation of out-of-hospital cardiac arrest in China: A systematic review and Utstein-style data analysis based on the Chain of Survival

AimOut-of-hospital cardiac arrest (OHCA) contributes to substantial mortality, but its resuscitation status in China is unknown. We aimed to describe and analyze out-of-hospital cardiac arrest in terms of Chain of Survival. MethodsWe systematically collected Utstein-style publications. Scenarios were prespecified, including either emergency medical service (EMS) assessing and attending cardiac arrest, resuscitation attempted by a bystander, resuscitation attempted by EMS, or in-hospital treatment. Random-effect models were used in a meta-analysis to pool rate ratios (RRs) with 95% confidence intervals (CIs) from multiple cohorts. ResultsWe analyzed 59 Chains involving 233,376 Chinese patients. The median rate of survival to discharge (interquartile range) was 0.35 % (0.06 %–0.61 %), 3.66 % (3.06 %–3.85 %), 1.23 % (0.57%–1.36%), and 2.73% (2.04%–3.42%) for four scenarios. The rate was significantly higher for bystander resuscitation than for EMS (P = 0.025) or in-hospital treatment (P = 0.301). However, only 4.8 % (1.6 %–8.2 %) of patients received bystander resuscitation, with no bystander defibrillation and a median response time of 9–15 minutes for EMS. Compared with controls without witnesses, arrest being witnessed and with bystander resuscitation increased rates of survival to discharge by 1.97 (I2 = 0, P for I2 = 0.583; pooled RR 2.97; 95% CI 1.47–6.02) and 6.79 (I2 = 0, P for I2 = 0.593; pooled RR 7.79; 95 % CI 3.40–17.84) times, following a markedly increasing trend. ConclusionsA low probability of first aid at multiple points is linked to poor survival following OHCA. It is essential to strengthen front links in the Chain of Survival in China, including among witnesses, bystanders, and emergency response.

Incidence and survival of neuroendocrine neoplasms in China with comparison to the United States.

Neuroendocrine neoplasms (NENs) are rare tumors characterized by variable biology and delayed diagnosis. However, the nationwide epidemiology of NENs has never been reported in China. We aimed to estimate the incidence and survival statistics of NENs in China, in comparison to those in the United States during the same period. Based on the data from 246 population-based cancer registries covering 272.5 million people of China, we calculated age-specific incidence on NENs in 2017 and multiplied by corresponding national population to estimate the nationwide incidence in China. The data of 22 population-based cancer registries were used to estimate the trends of NENs incidence from 2000 to 2017 through the Joinpoint regression model. We used the cohort approach to analyze the 5-year age-standardized relative survival by sex, age group, and urban-rural area between 2008 and 2013, based on data from 176 high-quality cancer registries. We used data from the Surveillance, Epidemiology, and End Results (SEER) 18 program to estimate the comparable incidence and survival of NENs in the United States. The overall age-standardized rate (ASR) of NENs incidence was lower in China (1.14 per 100,000) than in the United States (6.26 per 100,000). The most common primary sites were lungs, pancreas, stomach, and rectum in China. The ASRs of NENs incidence increased by 9.8% and 3.6% per year in China and the United States, respectively. The overall 5-year relative survival in China (36.2%) was lower than in the United States (63.9%). The 5-year relative survival was higher for female patients than male patients, and was higher in urban areas than in rural areas. The disparities in burden of NENs persist across sex, area, age group, and site in China and the United States. These findings may provide a scientific basis on prevention and control of NENs in the two countries.

Exploration of practice and optimization of strategies for conservation of cultivated land resources in contemporary China’s rural areas—Centering on black soil conservation and others

Cultivated land resources are the basic elements for rural development and farmers’ survival in China. Strengthening the protection of cultivated land is an important measure to ensure national food security and practice the strategy of “storing grain in the land and technology”, and it is also an inevitable requirement to promote the high-quality development of agriculture. The protection of cultivated land in contemporary China has gone through three stages: the initial exploration period of reconciliation between economic development and the number of cultivated land, the institutional development period of construction occupation and cultivated land quality management and protection, and the transformation and improvement period of “Trinity” in the new era. In the new era, cultivated land protection has achieved phased results, but it still faces practical constraints from the actors, technical environment, institutional environment and so on. In view of this, we should explore the breakthrough path to further promote cultivated land protection from the aspects of strengthening organizational guidance and technical training, strengthening the top-level design of differentiated cultivated land protection, strengthening the research and development of new technologies and the construction of agricultural technology extension system.

BRCA1 expression associated with the prognostic value of platinum-based chemotherapy for stage II-IV non-small cell lung cancer: A meta-analysis.

To explore the relationship between breast cancer susceptibility gene 1 (BRCA1) expression and the prognostic value of platinum-based chemotherapy for stage II-IV non-small cell lung cancer (NSCLC). PubMed, Web of Science, Embase, and Cochrane Library were searched from inception to August 2021, for retrieving literature related to BRCA1 expression and prognostic value of platinum-based chemotherapy in NSCLC patients. Stata 15.0 was employed for statistical analysis. A total of 15 articles were included. Compared with the low BRCA1 expression, its high expression negatively affected the overall survival of NSCLC patients treated with platinum-based chemotherapy (hazard ratio (HR) = 1.53, 95% confidence interval (CI): 1.01-2.31, P < 0.05). No significant difference was identified in the effect of both low and high BRCA1 expression on event-free survival (HR = 1.73, 95% CI: 0.98-3.05, P > 0.05). Subgroup analysis showed that significant differences existed in overall survival and event-free survival in Caucasian population; that is, compared with low BRCA1 expression, its high expression negatively affected the overall survival (HR = 1.79, 95% CI: 1.15-2.79, P < 0.05) and event-free survival (HR = 2.39, 95% CI: 1.43-3.97, P < 0.05). Nevertheless, there were no significant differences in overall survival and event-free survival in China. BRCA1 expression is correlated with the prognostic value of platinum-based chemotherapy for stage II-IV NSCLC patients. In Caucasian population, compared with low BRCA1 expression, its high expression has a negative effect on the overall survival and event-free survival in stage II-IV NSCLC patients after platinum-based chemotherapy; however, this correlation was not found in China.

Prevalence of major morbidities and outcome of all hospitalized neonates. A retrospective cohort study of Huai’an neonatal survivals

Background Reliable data for causal implication of neonatal survival in China are lacking. We assumed that by analyzing surviving data of in-hospital neonatal care based on all livebirths in Huai’an, prevalence of neonatal morbidity, mortality and causal relations may be derived comprehensively. Materials and methods Data of all regionally hospitalized neonates were retrospectively linked with corresponding whole livebirths (59,056) in 2015 as a cohort. Diagnoses of diseases and causes of deaths were redefined and categorized. Disease patterns, prevalence of morbidities, case-fatality rate (CFR), and cause-specific mortality rate (CSMR) referring to livebirths were presented. Perinatal and disease-specific risks of death were estimated by multivariable logistic regression. Results In 7,960 (134.8‰) hospitalized patients, 168 (2.1%) died in hospital (2.85‰ of livebirths). Prevalence of major morbidities were 76.8‰ hyperbilirubinemia, 57.4‰ pneumonia, 32.7‰ intraventricular hemorrhage, 20.7‰ sepsis, 20.2‰ birth asphyxia, 9.69‰ congenital anomalies (CA), and 5.30‰ respiratory distress syndrome (RDS). The CFR (CSMR) of major diseases were 30.4% (0.12‰) meconium aspiration syndrome, 17.6% (0.22‰) necrotizing enterocolitis, 14.1% (0.75‰) RDS, 9.09% (0.88‰) CA, 5.26% (0.07‰) bronchopulmonary dysplasia, 1.71% (0.36‰) sepsis and 1.51% (0.31‰) asphyxia. Overall mortality rates were 4.6% and 6.8% in the preterm and low birthweight, and >50% in those of <28 week gestation or <1000 g birthweight, respectively. Mortality risks associated with the perinatal and neonatal morbidities were markedly declined with variable magnitude by multivariable regression models. Conclusions The in-hospital neonatal survival datafile, depicted as the prevalence of major morbidities and CSMR of livebirth population in Huai’an, denoted overall and specific quality and efficiency of the perinatal-neonatal care system. Its concept and methodology should be relevant, and outcome extrapolated, to other countries or domestic regions, with similar socioeconomic development.

A retrospective study to assess the efficacy, safety, and drug survival of secukinumab in plaque psoriasis patients in China.

Secukinumab, a full human immunoglobulin G1κ monoclonal antibody that targets interleukin-17A, has demonstrated remarkable efficacy and appreciable tolerance in patients with moderate-to-severe psoriasis. However, data on its real-life performance, particularly on drug survival in China are limited. To investigate the efficacy, safety, and drug survival of secukinumab in Chinese patients with psoriasis, we conducted a monocentric retrospective study of 66 patients with moderate-to-severe psoriasis to followed-up for 52 weeks. At week 12, 86.4%, 57.6%, and 10.6% of the patients attained 75% improvement in psoriasis area and severity Index (PASI) score from baseline (PASI 75), PASI 90, and PASI 100 responses, respectively. The quality of life of patients markedly improved. The overall survival rate was 74.2%. Adverse events occurred in 30 patients (45.5%). The results revealed favorable efficacy, safety, and tolerability of secukinumab in the treatment of patients with psoriasis and provided data on drug survival in real-life clinical setting in China for the first time.

Investment in science can mitigate the negative impacts of land use on declining primate populations.

Changes in land use and the conversion of natural forests to agricultural fields and cattle pastures are threatening the survival of many species of wild animals, including nonhuman primates. Given its almost 1.4 billion people, China faces a difficult challenge in balancing economic development, human well-being, environmental protection, and animal conservation. We examined the effects of poverty, anthropogenic land use (cropland and pasture/grazing), human population growth, government investment in science and public attention to primates during the period from the 1980s to 2015 on primate population persistence in China. We analyzed these data using generalized mixed-effects models, structural equation models (SEM) and random forests (a machine learning technique). We found that 16 of 21 (76%) primate species in China, for which data are available, have experienced a population decline over the past 35 years. Factors contributing most to primate population decline included human poverty and the conversion of natural habitat to cropland. In contrast, the five species of primates that were characterized by recent population increases were the subjects of substantial government research funding and their remaining distribution occurs principally in protected areas (PAs). We argue that increased funding for research, the establishment and expansion of PAs, a national policy focused on reducing poverty, and educational programs designed to inform and encourage local people to participate in scientific investigation and wildlife protection, can mitigate the negative impacts of historical patterns of land conversion on primate population survival in China.

Protective effect of adult children's education on parental survival in China: Gender differences and underlying mechanisms

This study investigates whether adult children's education has a protective effect on parental survival, using data from all waves (2010–2018) of the China Family Panel Studies. We exploited the exogenous temporal and geographical variations in the enforcement of the 1986 compulsory schooling laws in China to construct an instrumental variable (IV) for adult children's education. The IV estimates indicated that the law-induced higher education of adult children led to sizeable improvements in the likelihood of paternal survival, although it had no significant effect on maternal survival. The protective effect on paternal survival was mainly driven by better-educated daughters, while sons' education had only a modest positive effect on maternal survival. Further evidence suggested that such heterogeneity by the gender of adult children might mainly come through more informal caregiving from better-educated daughters to older fathers with a limited role played by financial support from adult children.

Estimating cancer survival and prevalence with the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS): An empirical study in China.

BackgroundWe aimed to establish a new approach for surveillance of cancer prevalence and survival in China, based on the Medical-Insurance-System-based Cancer Surveillance System (MIS-CASS).MethodsWe constructed a standard procedure for data collection, cleaning, processing, linkage, verification, analysis, and estimation of cancer prevalence and survival (including both actual observations and model estimates) by conjoint use of medical insurance claims data and all-cause death surveillance data. As a proof-of-principle study, we evaluated the performance of this surveillance approach by estimating the latest prevalence and survival for upper gastrointestinal cancers in Hua County, a high-risk region for oesophageal cancer in China.FindingsIn Hua County, the age-standardised relative 5-year survival was 39·2% (male: 36·8%; female: 43·6%) for oesophageal cancer and 33·3% (male: 29·6%; female: 43·4%) for stomach cancer. For oesophageal cancer, better survival was observed in patients of 45–64 years compared with national average estimates, and women of <75 years had better survival than men. The 5-year prevalence rate in Hua County was 99·8/100,000 (male: 105·9/100,000; female: 93·3/100,000) for oesophageal cancer and 41·5/100,000 (male: 57·4/100,000; female: 24·5/100,000) for stomach cancer. For both of these cancers, the prevalence burden peaked at 65–79 years. The model estimates for survival and prevalence were close to the observations in real investigation, with a relative difference of less than 4·5%.InterpretationThis novel approach allows accurate estimation of cancer prevalence and survival with a short delay, which has great potential for regular use in general Chinese populations, especially those not covered by cancer registries.FundingThe National Key R&D Program of China (2016YFC0901404), the National Science & Technology Fundamental Resources Investigation Program of China (2019FY101102), the National Natural Science Foundation of China (82073626), the Taikang Yicai Public Health and Epidemic Control Fund (TKYC-GW-2020), the Beijing-Tianjin-Hebei Basic Research Cooperation Project (J200016), and the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority (XXZ0204).

A Comprehensive Analysis of Alterations in DNA Damage Repair Pathways Reveals a Potential Way to Enhance the Radio-Sensitivity of Esophageal Squamous Cell Cancer.

Esophageal squamous cell cancer (ESCC) is a common malignancy with a poor 5-year overall survival in China. Altered DNA damage repair (DDR) pathways are associated with a predisposition to cancer and contribute to therapeutic response and resistance in cancers. However, alterations of DDR pathway genes in ESCC are still largely unknown. In this study, we employed genome sequencing data of 192 samples, comparative genomic hybridization data of 123 cases, and gene expression microarray data of 119 patients to firstly perform a comprehensive analysis of the gene alterations of 7 DDR pathways in ESCC. Gene mutations and copy number variations (CNVs) were observed in all 7 DDR pathways, and especially, CNVs were the dominant alteration types. Compared with other pathways, two DNA double-strand break (DSB) repair pathways homologous recombination (HR) and non-homologous end joining (NHEJ), carried significant gene mutations and CNVs especially gene amplifications. Most genes including RAD54B, NBS1, RAD51B, and PRKDC were significantly amplified and over-expressed in ESCC. Amplification and high expression of DSB repair pathway genes were associated with poorer overall survival. Gene set variation analysis further showed that DSB repair pathways were up-regulated in ESCC. Besides, we firstly demonstrated that combination of mirin and NU7441, two inhibitors for HR and NHEJ respectively, with ionizing radiation treatment significantly enhanced DSBs, reduced clonogenic cell survival, inhibited cell proliferation, and promoted cell apoptosis in ESCC cells with DSB pathway gene amplification. These findings suggest that DSB repair pathways were significantly altered in ESCC and inhibiting DSB repair pathways might enhance the radio-sensitivity of ESCC with DSB repair up-regulation.

Survival After In-Hospital Cardiac Arrest in Critically Ill Patients: Implications for COVID-19 Outbreak?

The coronavirus disease 2019 (COVID-19) outbreak is placing a considerable strain on U.S. healthcare systems by requiring both significant acute resources and endangering healthcare team members th...

Social structure and demography of a remnant Asian elephantElephas maximuspopulation and the implications for survival

AbstractThe Asian elephantElephas maximusis at risk of extinction as a result of anthropogenic pressures, and remaining populations are often small and fragmented remnants, occupying a fraction of the species' former range. Once widely distributed across China, only a maximum of 245 elephants are estimated to survive across seven small populations. We assessed the Asian elephant population in Nangunhe National Nature Reserve in Lincang Prefecture, China, using camera traps during May–July 2017, to estimate the population size and structure of this genetically important population. Although detection probability was low (0.31), we estimated a total population size of c. 20 individuals, and an effective density of 0.39 elephants per km2. Social structure indicated a strong sex ratio bias towards females, with only one adult male detected within the population. Most of the elephants associated as one herd but three adult females remained separate from the herd throughout the trapping period. These results highlight the fragility of remnant elephant populations such as Nangunhe and we suggest options such as a managed metapopulation approach for their continued survival in China and more widely.

Rhizome in the shadows: transplantation of Korean Running Man in the rise of screen-capitalism

ABSTRACT In a potentially volatile policy environment as Mainland China, Korean Wave (hallyu) has penetrated into and continued survival in China through a new pattern of remakes in the context of bilateral tensions. Through a comparative examination of the Korean variety television programme Running Man and its Chinese remake Hurry up, Brothers, as a case study of the remakes, I explore how hallyu has become an amnyu (undercurrent) in the Chinese context. In this article, I conceptualize screen-capitalism to analyse and theorize emergent challenges and possibilities in a global context where collaborations flourish while conflicts remain, arguing for ‘transplantability’ as a rhizomatic quality that allows one screen culture to be connected or plugged into others outside of it, and that can be efficiently compatible with heterogeneous elements—other cultural, political, ideological, and linguistic communities—in diverse modes.

Corruption and private firms' survival in transition economies: Evidence from China

This article explores whether and how regional corruption determines private firms' survival in transition economies from a political favoritism perspective. We argue that regional corruption facilitates the likelihood of private firms' survival, but the magnitude to which private firms' survival responses to corruption is contingent on not only officials' power and power stability but also firms' power. Building on firm-level data and regional registered cases of corruption from 1998 to 2012, the findings confirm that corruption has a positive effect on private firms' likelihood of survival in China. Our studies also demonstrate that the positive effect is strengthened before the 16th National Congress of the Chinese Communist Party in 2002, in the case of regulated industry, regional leadership stability, large size, low export and privatized firms. Asset turnover and credit are viewed as the channels through which corruption fosters private firms' likelihood of survival.

Clinicopathologic and epidemiological characteristics of prognostic factors in post-surgical survival of colorectal cancer patients in Jiangsu Province, China

Poor survival among colorectal cancer (CRC) patients has been widely associated with clinico-epidemiological features and treatment regimen. In Jiangsu (China), however, it is not known which one of the prognostic factors explains the survival disparities among patients with CRC. This prospective study using 1078 patients (stages I-IV) that underwent surgery at Jiangsu Hospital, explored the relevant factors affecting the prognoses of right-side colon cancer (RCC), left-side colon cancer (LCC) and rectal cancer (ReC) patients. Of these cases, 234 (21.7%), 241 (22.4%) and 603 (55.9%) were found to have RCC, LCC and ReC respectively. Compared to LCC, RCC exhibited a greater proportion of older patients, poorly differentiated carcinomas, higher T-stage and higher TNM-stage. The overall survival (OS) for RCC was 60 vs.78 or 77 months for LCC or ReC respectively (P = 0.030). There were no significant differences in OS between LCC and ReC across the subgroups (P = 0.633). In multivariate analysis, RCC patients had age (>60 vs. ≤60 years, HR = 1.529, P = 0.019), N-stage (N1 vs. N0, HR = 4.056, P = 0.012) and M-stage (M1 vs. M0, HR = 3.442, P < 0.0001) as independent prognostic factors, whereas smoking status was found to be a predictor of mortality (smoker vs. nonsmoker, HR = 2.343, P = 0.017) for LCC. In addition, age (>60 vs. ≤60 years, HR = 2.199, P < 0.0001), alcohol consumption (drinker vs. nondrinker, HR = 0.510, P = 0.034), tumor grade (Poor vs. well/moderate, HR = 2.759, P = 0.031) and T-stage (T3-4 vs. T1-2, HR = 1.742, P < 0.0001) were found to be predictors of mortality for ReC. There were significant pairwise interactions across subgroups. Furthermore, significant differences were observed for LCC vs. RCC (OS, HR = 0.783, P = 0.039), but no statistically significant differences for ReC vs. RCC (P = 0.149) and LCC vs. ReC (P = 0.355). Nevertheless, significant differences remained between ReC vs. RCC for male (HR = 0.591, P = 0.009), drinker (HR = 0.396, P = 0.005), rural resident (HR = 0.437,P = 0.022), tumor grade (well/moderate, HR = 0.475, P = 0.022), T-stage (T1-2, HR = 0.362, P = 0.001), N-stage (N0, HR = 0.604, P = 0.011), M-stage(M0, HR = 0.401, P = 0.006) and TNM-stage (I-II, HR = 0.567, P = 0.005). Statistically significant differences were observed for LCC vs. RCC for gender (female, HR = 0.495, P = 0.003) and T-stage (T1-2, HR = 0.417, P = 0.010) as well as for LCC vs. ReC in patients with smoking habits (HR = 1.951, P = 0.002) and M-stage (M0, HR = 2.291, P = 0.003). These findings suggest that the variations in CRC post-surgical survival in China may be primarily explained with the clinicopathologic features and epidemiological characteristic of the patients. Patients with RCC had significantly worse OS compared to both LCC and ReC in several subgroups.

PCN168 GLOBAL BURDEN OF WALDENSTRÖM MACROGLOBULINEMIA (WM): A SYSTEMATIC LITERATURE REVIEW (SLR) AND EVIDENCE GAP ANALYSIS

To review the global clinical, economic, and humanistic burden of WM and evaluate current evidence data gaps. A SLR using PubMed to identify WM-related interventional, observational, qualitative, and economic studies published January 2013-September 2018. Inclusion criteria: human clinical studies, N>40, non-case reports or editorials, English manuscripts available. Of 1146 evaluable publications, 51 were included based on above search criteria. WM incidence ranged from 0.3-0.57/100,000 person-years in US studies, with most data showing decreased or stable incidence over time. WM incidence appeared similar in Japan and Taiwan but higher in Sweden (1.05/100,000). Recent data trends suggest significantly increased WM-related survival, though 5-year survival rates vary (52%-78%) in US studies. European data demonstrate similar survival rates and trends (5-year survival ∼70%) but lower survival in China (61.8%). Across countries, WM appears to be more common in men and in elderly. Mortality rates are also shown to be higher in elderly and male patients. US data suggest higher incidences in Caucasian patients but reduced survival for African American and Hispanic patients. Compared to Westerners, Chinese patients demonstrated a higher male-to-female ratio, younger diagnosis age, higher rates of leukocytopenia, thrombocytopenia, and pancytopenia, and reduced asymptomatic WM. WM-related serious complications are reported, including secondary malignancies, thrombosis, renal diseases, symptomatic hyperviscosity, and autoimmune manifestations. Although novel treatments contribute to improved survival, they significantly increase costs (mean Medicare costs in first treatment year: $9,464 before 2000 to $29,490 after 2008; most recent data available). Data on the humanistic burden of WM are lacking. This study reviewed the burden of WM across the regions (US, EU, and China). Although rare, WM results in significant clinical (e.g., incidence, complications, survival) and economic burden and unmet needs, with new treatments associated with clinical benefits but increased costs. Data gaps on WM-burden exist, future studies are suggested.