Survival Patterns Research Articles

Patterns of First Recurrence and Oncological Outcomes in Locally Advanced Cervical Cancer Patients: Does Surgical Staging Play a Role?

We aimed to determine whether surgical aortic staging by minimally invasive paraaortic lymphadenectomy (PALND) affects the pattern of first recurrence and survival in treated locally advanced cervical cancer (LACC) patients when compared to patients staged by imaging (noPALND). This study was a multicenter observational retrospective cohort study of patients with LACC treated at tertiary care hospitals throughout Spain. The inclusion criteria were histological diagnosis of squamous carcinoma, adenosquamous carcinoma, and/or adenocarcinoma; FIGO stages IB2, IIA2-IVA (FIGO 2009); and planned treatment with primary chemoradiotherapy between 2000 and 2016. Propensity score matching (PSM) was performed before the analysis. After PSM and sample replacement, 1092 patients were included for analysis (noPALND n = 546, PALND n = 546). Twenty-one percent of patients recurred during follow-up, with the PALND group having almost double the recurrences of the noPALND group (noPALND: 15.0%, PALND: 28.0%, p < 0.001). Nodal (regional) recurrences were more frequently observed in PALND patients (noPALND:2.4%, PALND: 11.2%, p < 0.001). Among those who recurred regionally, 57.1% recurred at the pelvic nodes, 37.1% recurred at the aortic nodes, and 5.7% recurred simultaneously at both the pelvic and aortic nodes. Patients who underwent a staging PALND were more frequently diagnosed with a distant recurrence (noPALND: 7.0%, PALND: 15.6%, p < 0.001). PALND patients presented poorer overall, cancer-specific, and disease-free survival when compared to patients in the noPALND group. After treatment, surgically staged patients with LACC recurred more frequently and showed worse survival rates.

Ant evolution: Amber revelations of extinction, survival and recovery

Ant fossils from the Cretaceous are rare but critical for understanding the early evolution of this incredibly successful group of animals. New amber fossils fill important gaps, revealing patterns of death, survival, and radiation around the end Cretaceous extinction.

Natural history of undifferentiated pleomorphic sarcoma: Experience from the US Sarcoma Collaborative.

Undifferentiated pleomorphic sarcoma (UPS) is a relatively rare but aggressive neoplasm. We sought to utilize a multi-institutional US cohort of sarcoma patients to examine predictors of survival and recurrence patterns after resection of UPS. From 2000 to 2016, patients with primary UPS undergoing curative-intent surgical resection at sevenacademic institutions were retrospectively reviewed. Epidemiologic and clinicopathologic factors were reviewed by site of origin. Overall survival (OS), recurrence-free survival (RFS), time-to-locoregional (TTLR),time-to-distant recurrence (TTDR), and patterns of recurrence were analyzed. Of the 534 UPS patients identified, 53% were female, with a median age of 60 and median tumor size of 8.5 cm. The median OS, RFS, TTLR, and TTDR for the entire cohort were 109, 49, 86, and 46 months, respectively. There were no differences in these survival outcomes between extremity and truncal UPS. Compared with truncal, extremity UPS were more commonly amenable to R0 resection (87% vs. 75%, p = 0.017) and less commonly associated with lymph node metastasis (1% vs. 6%, p = 0.031). R0 resection and radiation treatment, but not site of origin (extremity vs. trunk) were independent predictors of OS and RFS. TTLRrecurrence was shorter for UPS resected with a positive margin and for tumors not treated with radiation. For patients with resected extremity and truncal UPS, tumor size >5 cm and positive resection margin are associated with worse survival OS and RFS, irrespectively the site of origin. R0 surgical resection and radiation treatment may help improve these survival outcomes.

Adjuvant Transarterial Chemoembolization Plus Immunotherapy for Huge Hepatocellular Carcinoma: A Propensity Score Matching Cohort Study.

The prognosis of patients with huge hepatocellular carcinoma (huge HCC, diameter ≥10 cm) is poor owing to the high early recurrence rate. This study aimed to explore the clinical value of postoperative adjuvant transarterial chemoembolization (PA-TACE) plus programmed cell death-1 (PD-1) inhibitors for huge HCC. Data from consecutive huge HCC patients treated with hepatectomy during June 2017 and July 2022 were retrospectively collected. Baseline differences were balanced between huge HCC patients who underwent PA-TACE with (AIT group) or without PD-1 inhibitors (AT group) by propensity-score matching (PSM). We compared recurrence-free survival (RFS), overall survival (OS) and recurrence patterns between the two groups. Independent risk factors for RFS and OS were confirmed by Cox regression analysis, and subgroup analysis was also conducted. A total of 294 patients were enrolled, and 77 pairs of patients in the AIT and AT groups were matched by PSM. The 1-year and 2-year RFS were 49.9% and 35.7% in the AIT group compared to 24.7% and 15.5% in the AT group respectively (p<0.001). The 1-year and 2-year OS were 83.6% and 66.9% in the AIT group compared to 50.6% and 36.8% in the AT group respectively (p<0.001). There were no significant differences in recurrence patterns between the two groups. Multivariable analysis demonstrated that combined therapy of PA-TACE plus PD-1 inhibitors was a protective factor related to both RFS and OS. PA-TACE plus PD-1 inhibitors could improve survival outcomes for huge HCC patients.

Order and timing of infection with different parasite life stages impacts host and parasite life histories.

Co-exposure to multiple parasites can alter parasite success and host life history when compared to single infections. These infection outcomes can be affected by the order of parasite arrival, the host immune response, and the interspecific interactions among co-infecting parasites. In this study, we examined how the arrival order of two trematode parasites, Schistosoma mansoni and Echinostoma caproni, influenced parasite ecology and the life history of their snail host, Biomphalaria glabrata. Snail hosts were exposed to E. caproni cercariae before, with, and after their exposure to S. mansoni miracidia. We then measured the effects of this timing on infection prevalence, infection intensity of E. caproni metacercariae, and cercarial output of S. mansoni, as well as on snail reproduction and survival. Snails infected only with S. mansoni and snails exposed to E. caproni after S. mansoni both shed more cercariae than simultaneously exposed snails. Additionally, S. mansoni prevalence was lower in snails that were first exposed to E. caproni compared to snails that were exposed to E. caproni after S. mansoni. Moreover, snails exposed to E. caproni before S. mansoni did not differ in their survival compared to control snails, whereas simultaneously exposed snails and snails exposed to E. caproni after S. mansoni had lower survival than control snails. Combined, this prevalence and survival data suggest a potential protective role of early E. caproni exposure. The timing of E. caproni exposure impacts S. mansoni establishment and reproduction, but host survival patterns are likely driven by S. mansoni prevalence alone.

Clinical impact of IDH1 mutations and MGMT methylation in adult glioblastoma

BackgroundImpact of Isocitrate dehydrogenase1 (IDH1) and O6-methylguanine-DNA methyltransferase (MGMT) in glioblastoma (GBM) have been of great interest due to their implications in prediction of prognosis of several types of cancer. It was aimed to investigate the clinical role of IDH1 mutation and MGMT methylation pattern among GBM patients versus non-neuro-oncological diseases (NND) patients and their impact on survival criteria.MethodsFormalin-fixed paraffin-embedded (FFPE) tissue sections of 58 GBM and 20 non-neuro-oncological diseases patients were recruited and IDH1 mutation and MGMT methylation was detected using Cast-PCR technology and Methyl II quantitative PCR approach, respectively. Results were assessed with other clinicopathological criteria and survival patterns.ResultsIDH1 mutation was detected among 15 GBM cases (15/58) and it was not reported among NND (P = 0.011). Receiver operating characteristic (ROC) curve was plotted to discriminate between MGMT methylation among studied groups. Patients with MGMT methylation ≥ 66% were reported as high methylation, which was recorded significantly in 51.7% and 100% of GBM cases and NND, respectively. Both showed significant difference with performance status, while MGMT methylation was significantly related with tumor size and tumor location. IDH1 mutation and MGMT methylation reported significant increase with GB patients revealed complete response to treatment. Survival pattern was better for IDH1 mutation and MGMT high methylation as compared to IDH1 wild type or MGMT low–moderate methylation, respectively, and favorable survival was detected when both were combined than using either of them alone.ConclusionDetection of IDH1 mutation and MGMT methylation among GB patients could aid in prediction of their response to treatment and their survival patterns, and their combination is better than using any of them alone.

Lymph node volume predicts survival in esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy and surgery.

Large primary tumor volume has been identified as a poor prognostic factor of esophageal squamous cell carcinoma (ESCC) treated with definitive concurrent chemoradiotherapy (CCRT). However, when neoadjuvant CCRT and surgery are adopted, the prognostic impact of primary tumor and lymph node (LN) volume on clinical outcomes in ESCC remains to be elucidated. This study included 107 patients who received neoadjuvant CCRT and surgery for ESCC. The volume of the primary tumor and LN was measured using radiotherapy planning computed tomography scans, and was correlated with overall survival (OS), disease-free survival (DFS), and cancer failure pattern. The median OS was 24.2 months (IQR, 11.1-93.9) after a median follow-up of 18.4 months (IQR, 8.1-40.7). The patients with a baseline LN volume > 7.7 ml had a significantly worse median OS compared to those with smaller LN volume (18.8 vs. 46.9 months, p = 0.049), as did those with tumor regression grade (TRG) 3-5 after CCRT (13.9 vs. 86.7 months, p < 0.001). However, there was no association between OS and esophageal tumor volume (p = 0.363). Multivariate analysis indicated that large LN volume (HR 1.753, 95% CI 1.015-3.029, p = 0.044) and high TRG (HR 3.276, 95% CI 1.556-6.898, p = 0.002) were negative prognostic factors for OS. Furthermore, large LN volume was linked to increased locoregional failure (p = 0.033) and decreased DFS (p = 0.041). In conclusion, this study demonstrated that large LN volume is correlated with poor OS, DFS, and locoregional control in ESCC treated with neoadjuvant CCRT and esophagectomy.

Registration, incidence patterns, and survival trends of central nervous system tumors among children in Germany 1980-2019: An analysis of 40years based on data from the German Childhood Cancer Registry.

Tumors of the central nervous system (CNS) are the second most common type of pediatric cancer in Germany. We aimed to describe registration practice, incidence, and survival patterns for childhood CNS tumors in Germany for the past 40years. Including all CNS tumor cases in children diagnosed at ages 0-14years registered at the German Childhood Cancer Registry (GCCR) in 1980-2019 (for survival analysis 1980-2016), we calculated age-specific and age-standardized incidence rates (ASIR) over time, average annual percentage changes (AAPC), and 1- and 5-year overall survival. While we observed a pronounced increase in ASIR after the establishment of the GCCR during the 1980s, ASIR for all pediatric CNS tumors combined continued to increase markedly from 28.6 per million in 1990-1999 to 43.3 in 2010-2019 (AAPC=2.7% in 1991-2010, AAPC=0.3% in 2010-2019). The 5-year overall survival from CNS tumors improved from 63% in the 1980s, 70% in the 1990s to 79% in 2010-2016. These improvements have occurred across all age groups. Children diagnosed with ependymomas and choroid plexus tumors experienced the strongest increase (from 54% to 81%). Observed increases in incidence rates for pediatric CNS tumors are likely only partially caused by actual increasing case numbers. The majority is a function of improved registration and, to a minor extent, improvements in diagnostics. Survival from pediatric CNS tumors has, by and large, improved consistently, leading to a growing population of childhood cancer survivors with diverse health biographies and risk of lifelong adverse impact on health and wellbeing.

Endometriosis-associated ovarian cancer: a different clinical entity

ObjectiveTo compare survival outcomes and patterns of recurrence between endometriosis-associated ovarian cancer patients and non-endometriosis-associated ovarian cancer patients.MethodsThis retrospective study included data of consecutive patients with endometrioid or clear cell...

Abstract 4813: Demographic, treatment, and survival patterns in Hispanic vs. non-Hispanic patients with lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia: A national retrospective analysis from the National Cancer Database

Abstract Background: Lymphoplasmacytic lymphoma (LPL) is a rare type of non-Hodgkin B cell lymphoma. Waldenstrom macroglobulinemia (WM) is a form of LPL that presents with overproduction of IgM monoclonal protein. The understanding and treatment of LPL/WM has improved. However, few studies analyze LPL/WM in Hispanic (HI) patients specifically. This study aims to evaluate demographics, treatment, and survival patterns in HI vs. Non-Hispanic (NH) patients with LPL/WM. Methods: Data were analyzed on LPL/WM patients in the US reported to the NCDB from 2004-2019. Demographic and treatment characteristics were compared between ethnic groups. Kaplan-Meier and Cox regression analyses were used to compare overall survival (OS) between HI and NH. Multivariate analysis and propensity score matching were performed with adjustment for age, stage, co-morbidity score, insurance status, type of facility and great circle distance (GCD). Results: 17,915 patients were identified. 92% were NH, 3% were HI. Most patients were male in both NH and HI (p = 0.120). The median age at diagnosis for HI was 68 vs. 71 for NH (p &amp;lt; 0.001). Most HI and NH were white (87% HI, 91% NH p &amp;lt; 0.001). More HI were uninsured (8% HI, 1% NH p &amp;lt; 0.001) and were less likely to have government sponsored insurance (60% HI, 66% NH p &amp;lt; 0.001). Regarding income, most NH (42%) were in the $63,000+ bracket while most HI were in the $48,000-$62,999 bracket. Regarding education, reported in percent quartiles with no high school degree, most HI (41%) were in the &amp;gt; 21% bracket while most NH (35%) were in the 7-12.9% bracket (p &amp;lt; 0.001). Most HI (43%) were treated at academic/research programs; most NH were treated at comprehensive community cancer programs (38.4%, p &amp;lt; 0.001). Regarding comorbidities score, 9% of HI scored ≥ 2 vs 8% of NH (p 0.029). Regarding GCD, the median distance in miles between the patient’s residence and the hospital that reported the case, HI lived at a median of 6.7 miles vs 9 miles for NH (p &amp;lt; 0.001). Regarding treatment, 68% of HI were given treatment vs. 62% of NH (p &amp;lt; 0.001). There was no difference in mortality between HI vs. NH (30 day mortality p = 0.322; 90 day mortality p = 0.217). On survival analysis, the survival probability at 2, 5 and 10 years of HI vs NH were 81% vs 83%, 69% vs 68%, and 52% vs 46%, respectively. The median survival time (MS) was 10.6 years for HI vs 9 years for NH. There was no OS difference between HI vs. NH (p = 0.47). On multivariate analysis, there were no independent variables associated with better or worse OS. The propensity matched analysis showed no MS difference between HI vs NH (8.96 y vs. 8.74 y). Conclusion: We identified ethnic differences in age, race, insurance, education, income, location of treatment, GCD, staging, and treatment patterns. However, there was no statistically significant ethnic difference in MS or OS. Citation Format: Maria Elena Fierro, Heidi Latiolais, Qianquian Liu, Joel Michalek, Adolfo Enrique Diaz Duque. Demographic, treatment, and survival patterns in Hispanic vs. non-Hispanic patients with lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia: A national retrospective analysis from the National Cancer Database [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4813.

Abstract 3932: Multi-omics characterization of molecular features and global-local genomic ancestry analysis of colorectal cancer in Hispanic-Latinos

Abstract Introduction: Clinical factors and molecular characteristics play pivotal roles in shaping therapeutic strategies and prognoses in colorectal cancer (CRC), the second leading cause of cancer-related mortality in the United States. Despite an overall decline in mortality, the Hispanic/Latino (H/L) population in the Los Angeles area exhibits mortality rates up to 20% higher than their Caucasian American counterparts, often with diagnoses at a younger age and advanced disease stages. Few studies have utilized substantial H/L sample sizes and integrated comprehensive clinical and multi-omics data to conduct integrative translational analysis of reported genomic alterations and their implications for colorectal tumorigenesis. Methods: We collected clinical, DNA, and RNA sequencing data from 36 primary CRC Tumor/Normal (T/N) samples and 82 primary CRC T/N samples within the H/L population in the Los Angeles area through the Participant Engagement and Cancer Genome Sequencing (PE-CGS) Network and the Oncology Research Information Exchange Network (ORIEN), respectively. Additionally, we retrieved two CRC samples with spatial transcriptomic (ST) data from the 10xGenomics database. This data underwent Whole Exome and RNA sequencing analysis. Furthermore, we conducted global and local genomic ancestry analyses to establish correlations between self-ancestral identification and the five main superpopulations. ST data was analyzed using recently released bioinformatics tools. Clinical and genomic data were integrated. Results: In these studies, distinct age-of-onset, Amerindian (AMR), and survival patterns were observed, with significant mutations identified in key genes, including APC, TP53, KRAS, and PIK3CA. Cancer heterogeneity was evident, influenced by mutation type, microsatellite instability, subsite, and ethnicity. Ancestry analysis indicated genetic diversity, with a predominant AMR heritage and cases showcasing substantial European genetic proportions alongside AMR ancestry. Additionally, RNA sequencing has been conducted, with ongoing transcriptomic analysis in both studies, and the results are set for presentation at the annual meeting. The ST analysis generated initial maps, delineating diverse cellular populations and revealing the samples' distinct immunological and inflammatory signals. Conclusion: Our study has delved into the molecular profiling of CRC tumors among H/L patients, contributing essential insights into the DNA and RNA level characterization of CRC tumors and the multifaceted clinical and genomic heterogeneity within our aimed population. It also provides crucial insights into CRC tumor heterogeneity and the tumor microenvironment. These findings serve as the cornerstone for forthcoming sample analyses within our PE-CGS project to potentially lead to the development of personalized treatments. Citation Format: Enrique I. Velazquez Villarreal, Seeta Rajpara, Yuxin Jin, Mackenzie Postel, Brigette Waldrup, Flemming Wu, Donna Loza, Heinz-Josef Lenz, David W. Craig, John D. Carpten. Multi-omics characterization of molecular features and global-local genomic ancestry analysis of colorectal cancer in Hispanic-Latinos [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3932.

Abstract 7656: Clinicogenomic anlaysis reveals a role for TP53 mutations in distant progression of high-grade glioma

Abstract Purpose: High-grade glioma (HGG), the most common form of primary brain tumor, is highly lethal and treatment options remain limited. Despite advances in genomic technologies, there are few molecular biomarkers to guide precision medicine for HGG. Here, we aimed to identify the clinicogenomic features associated with HGG prognosis and recurrence patterns. Methods: Our single-institution retrospective analysis included 220 patients initially diagnosed with adult HGG (grade 3 or 4) who underwent next-generation sequencing targeting 82 brain tumor-relevant genes. The patients were categorized according to the 2021 WHO classification and their clinical status, survival, genomic profile, and recurrence patterns were analyzed. Results: At a median follow-up of 23 months (ranges, 2-59 months), 180 patients (82%) showed either progression or recurrence. A total of 15% of patients were reclassified under the 2021 WHO classification, revealing a clear separation of progression-free survival (PFS) and overall survival (OS) curves between grades 3 and 4 gliomas. We found that TP53 mutations were significantly associated with the occurrence of distant progression, especially in grade 4 gliomas. Additionally, TP53 mutations were more common in patients with higher Ki67 index and subependymal/leptomeningeal seeding, indicating an increased risk of distant progression in TP53-mutated grade 4 glioma patients. Following multivariate Cox regression analysis, TP53 mutations were independent predictors of OS (hazard ratio [HR]=1.47, P=0.039) and distant PFS (HR=1.71, P=0.005). Conclusion: Considering the elevated risk of distant progression in grade 4 gliomas with TP53 mutations, our results underscore the necessity for additional research into the most effective treatment approaches for these patients. Keywords: high-grade glioma, TP53, pattern of failure, distant progression, next-generation sequencing Citation Format: Byung-Hee Kang, Seungbok Lee, Joo Ho Lee. Clinicogenomic anlaysis reveals a role for TP53 mutations in distant progression of high-grade glioma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7656.

Abstract 873: Elucidating immune-related gene transcriptional programs via factorization of large-scale RNA profiles

Abstract Background: Despite the recent success in Immune checkpoint blockade (ICB) therapy, limited patients benefit due to immune-related adverse events or treatment resistance, especially in solid tumors. To overcome these hurdles, understanding the molecular mechanisms behind treatment response is essential. However, the current lack of immune gene transcriptional programs (GTPs) hampers data-driven immunological discovery. Constructing immunity-specific knowledgebases with rigorously curated gene sets (irGSs) and rich immunological language can unlock new insights, enabling interpretation of high-throughput immune microenvironment profiling studies and fostering personalized, effective cancer treatments. Methods: We collected 83 BulkRNAseq datasets from the ImmuneSigDB. These datasets contain 1826 samples challenged with infections, cytokines or immunological perturbations of different kinds and magnitude, possessing yet-to-be discovered immune functions that lie beneath the transcriptomic profiles. Using non-negative matrix factorization (NMF), we identified gene sets with coordinated expression. We used CITE-seq and selected scRNAseq to annotate the immunological functions of each gene set and validated the clinical utilities of these gene sets from different aspects using data from Cancer Genome Atlas Program (TCGA) pan-cancer, ICB cohorts and a 10X Genomics Visium FFPE Human Breast Cancer spatial slide. Results: We presented 19 lymphoid-data derived and 9 myeloid-data derived gene sets (irGSs), encompassing a diverse array of immune functions. Through extensive validation using BulkRNAseq, scRNAseq and spatial transcriptomics data, we revealed six irGSs-defined pan-cancer microenvironment subtypes in TCGA with significantly distinct survival patterns regardless of cancer types. Moreover, irGSs are associated with T cell exhaustion phenotypes, which in turn well predicted (classification accuracy of 72%) Nivolumab response using 104 treatment-naïve melanoma patients. Lastly, irGSs simultaneously isolated out tumor regions and highlighted immune infiltration with high specificity in breast cancer spatial transcriptomics H&amp;E image. Conclusions: These pioneering gene sets, originally derived from non-cancerous experiments, hold tremendous promise for cancer research across diverse contexts. Similarities between cancerous and sepsis immune microenvironments underscore their wide applicability. By studying gene set activities, immunologists can gain profound insights into cancer survival drivers, unravel the intricacies of ICB treatment mechanisms, and potentially conquer therapeutic resistance. These translational utilities herald a transformative era in cancer immunotherapy and open new frontiers in the fight against cancer. Citation Format: Shan He, Vakul Mohanty, Matthew Gubin, Hind Rafei, Rafet Basar, Merve Dede, Xianli Jiang, Yukun Tan, Maura Gillison, Katayoun Rezvani, Weiyi Peng, Ken Chen. Elucidating immune-related gene transcriptional programs via factorization of large-scale RNA profiles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 873.

Abstract 2232: Association between sleep characteristics and cancer survival: Findings from the UK Biobank study

Abstract Background Sleep characteristics have been associated with patient outcomes after cancer. We aimed to appraise the causal relationship of chronotype, sleep duration, insomnia, and snoring with cancer survival. Methods This large prospective cohort study enrolled 38350 cancer survivors aged ≥40 years from the UK Biobank between 2004 and 2022. Habitual sleep characteristics were obtained from the self-reported baseline questionnaire, including chronotype, sleep duration, insomnia, and snoring. Cox proportional hazards regression models were applied to evaluate the association between sleep characteristics and cancer survival, then one sample Mendelian randomization (MR) analyses were further used to validate these causal relationships. In particular, restricted cubic splines (RCS) and non-linear MR analyses were applied to assess the possible nonlinear association between sleep duration and cancer survival. Results Among 38350 study participants (mean [SD] age, 59.8 [7.3] years; 24150 [63.0%] males; 35534 [92.7%] White individuals), 12671 (33.1%) reported evening preference chronotype; 9050 (23.6%) reported short and 3773 (9.8%) reported long sleep duration;12274 (32.0%) reported snoring; and 30426 (79.4%) reported experiencing insomnia sometimes or usually. During up to 18 years of follow-up, 6274 deaths occurred. Multivariable regression models showed that evening preference (HR = 1.09, 95% CI: 1.03 to 1.15), short (HR = 1.14, 95% CI: 1.07 to 1.21) and long sleep duration (HR = 1.37, 95% CI: 1.28 to 1.48), insomnia (HR = 1.14, 95% CI: 1.09 to 1.21) and snoring (HR = 0.83, 95% CI: 0.78 to 0.87) were associated with death among pan to cancer survivors. Restricted cubic splines suggested nonlinear associations between sleep duration and death after cancer (nonlinear P &amp;lt; 0.001). In the one-sample MR, genetically predicted sleep duration (HR = 0.71, 95% CI: 0.56 to 0.90) and snoring (HR = 1.18, 95% CI: 1.05 to 1.34) demonstrated a reversed cancer survival pattern compared to multivariable regressions. A nonlinear U-shape association between sleep duration and cancer survival was observed in restricted cubic spline analyses (P &amp;lt; 0.001) but not evident when evaluating by nonlinear MR (P &amp;gt; 0.05). Conclusions Evening preference chronotype, insomnia, snoring, and short sleep duration are likely to be causally associated with a higher risk of death among cancer survivors, whilst long sleep duration does not appear to be a causal factor. Citation Format: Jiajing Che, Jiali Lv, Keyu Pan, Tiantian Sun, Chao Cao, Shengxu Li, Tao Zhang, Fuzhong Xue, Lin Yang. Association between sleep characteristics and cancer survival: Findings from the UK Biobank study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2232.

Recurrence patterns after complex multimodality therapy and hepatic arterial infusion for colorectal liver metastases: A reflection of biology and technique.

We characterized colorectal liver metastasis recurrence and survival patterns after surgical resection and intraoperative ablation ± hepatic arterial infusion pump (HAIP) placement. We estimated patterns of recurrence and survival in patients undergoing contemporary multimodal treatments. Between 2017 and 2021, patient, tumor characteristics, and recurrence data were collected. Primary outcomes included recurrence patterns and survival data based on operative intervention. There were 184 patients who underwent hepatectomy and intraoperative ablation. Sixty patients (32.6%) underwent HAIP placement. A total of 513 metastases were ablated, median total of 2 ablations per patient. Median time to recurrence was 31 [22-40] months. Recurrence patterns included tumor at ablative margin on first scheduled postoperative imaging (8, 4.3%), local tumor recurrence at ablative site (69, 37.5%), and non-ablated liver tumor recurrence (38, 20.6%). In patients who underwent HAIP placement, the rate of liver recurrence was reduced (45% vs 70.9%, p = 0.0001). Median overall survival was 64 [41-58] months and prolonged survival was associated with HAIP treatment (85 [66-109] vs 60 [51-70] months. Hepatic recurrence is common and combination of intraoperative ablation and HAIP treatments were associated with prolonged survival. These data may reflect patient selection however, future work will clarify preoperative tumor and patient characteristics that may better predict recurrence expectations.

O77: Invasive intraductal oncocytic papillary neoplasms (IOPN) and adenocarcinomas arising from Intraductal papillary mucinous neoplasms (IPMN): adjuvant chemotherapy, patterns of recurrence and survival

Abstract Introduction Invasive intraductal oncocytic papillary neoplasms (IOPNs) are extremely rare and are increasingly being recognised as their own entity, distinct from intraductal papilliary mucinous neoplasism subtypes (IPMN). Their clinicopathologic behaviour, recurrence patterns, response to adjuvant chemotherapy and long-term survival outcomes are unknown compared to adenocarcinomas arising from IPMN but were investigated in the present study. Methods Patients undergoing pancreatic resection between 2010-2020 for invasive IOPNs and adenocarcinoma arising from IPMNs were identified retrospectively from 18 academic pancreatic centers worldwide. Survival analyses were conducted to compare outcome measures between IOPNs and IPMN precursor epithelial subtypes and invasive components. Results Of the 459 patients with invasive IOPN/IPMNs, 20 patients had an invasive IOPN (median age,69; male,n=11), the majority of which were in the pancreatic head (75%) and underwent either a Whipples procedure (40%) or PPPD (35%). After a median follow-up of 6 years, 45% of invasive IOPNs developed recurrence (1-year,30.0%; 5-year,69.2%) and 40% survived follow-up (2-year survival 55.0%, 5-year survival, 30.8%). Recurrence rates and survival of invasive IOPNs were higher than colloid IPMNs (n=64) (p=0.031 and p=0.007) and comparable with ductal IPMNs (n=331) as well as gastric (n=54) and pancreatobiliary (n=111) IPMN subtypes. Invasive IOPN had significantly lower cancer-specific survival compared to colloid carcinomas (p&amp;lt;0.001). Adjuvant chemotherapy did not improve rates of recurrence in invasive IOPN and IPMN subtypes (p&amp;gt;0.05). Conclusions Invasive IOPNs are more aggressive than previously suspected and should be regarded as their own entity. Adjuvant chemotherapy does not reduce rates of recurrence regardless of neoplasm type.

BIOLOGÍA REPRODUCTIVA DEL CHINCHERO ENANO O CHINCHERO EXCAVADOR XIPHORHYNCHUS FUSCUS

Despite recent advances, the knowledge scarcity on Furnariidae forest species reproduction continues to bias ideas and limit the understanding of avian life history. We studied the reproductive biology of the Lesser Woodcreeper (Xiphorhynchus fuscus; Dendrocolaptinae), which nests in tree cavities, to contribute observations toward ideas about evolution and ecology. In the Atlantic Forest of Argentina (2007–2022), we inspected 26 nests (total: 333 visits), color-banded nine adults, conducted 180 h of focal observations at 11 nests, and analyzed patterns of nest survival and parental care using linear models in R. Lesser Woodcreepers laid two or three white eggs (mean±SE = 2.8±0.1; N = 16) on a bed of bark flakes. One adult (possibly female) carried out construction, incubation, feeding, and nest hygiene, but we frequently observed a second adult (possibly male) singing from 'preferred' perches, sometimes approaching the nest tree in response to alarm calls from the nest. Attending adults brought bark to their nests throughout incubation (19 days) and occasionally during nestling (21 days; range: 20–23). In the absence of adults, eggs and young nestlings were left covered with bark. Nest attention (daytime percentage an adult was inside the cavity) was 63±3% during incubation, fell to 38±9% in the first 4 days after hatching, and approximately 0% after nestlings were 10 days old and had open pin feathers. Nestlings were fed almost exclusively arthropods, and the feeding rate increased as brooding declined. Nest survival was 0.984 (95% CI: 0.970–0.992) daily or 0.50 (0.26–0.70) for the nesting period. For four of six broods, when nestlings fledged, a second adult (possibly a male) participated minimally. Our observations cover the mating system and division of parental care in Furnariidae, the advantages of covering eggs and nestlings, and the possibility that males increase parental care during the vulnerable fledgling stage.

Adrenocortical Cancer in the Real World: A Comprehensive Analysis of Clinical Features and Management from the Turkish Oncology Group (TOG)

IntroductionAdrenocortical carcinoma (ACC) is a rare yet highly malignant tumor associated with significant morbidity and mortality. This study aims to delineate the clinical features, survival patterns, and treatment modalities of ACC, providing insights into the disease's prognosis. Materials and MethodsA retrospective analysis of 157 ACC patients was performed to assess treatment methodologies, demographic patterns, pathological and clinical attributes, and laboratory results. The data were extracted from the hospital's database. Survival analyses were conducted using the Kaplan–Meier method, with univariate and multivariate analyses being performed through the log-rank test and Cox regression analyses. ResultsThe median age was 45, and 89.4% had symptoms at the time of diagnosis. The median tumor size was 12 cm. A total of 117 (79.6%) patients underwent surgery. A positive surgical border was detected in 26 (24.1%) patients. Adjuvant therapy was administered to 44.4% of patients. The median overall survival for the entire cohort was 44.3 months. Median OS was found to be 87.3 months (95% confidence interval [CI] 74.4-100.2) in stage 2, 25.8 (95% CI 6.5-45.1) months in stage 3, and 13.3 (95% CI 7.0-19.6) months in stage 4 disease. Cox regression analysis identified age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as significant factors associated with survival in patients with nonmetastatic disease. In metastatic disease, only patients who underwent surgery exhibited significantly improved overall survival in univariate analyses. ConclusionACC is an uncommon tumor with a generally poor prognosis. Understanding the defining prognostic factors in both localized and metastatic diseases is vital. This study underscores age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as key prognostic determinants for localized disease, offering critical insights into the complexities of ACC management and potential avenues for targeted therapeutic interventions.

Impact of Tumor-intrinsic Molecular Features on Survival and Acquired Tyrosine Kinase Inhibitor Resistance in ALK-positive NSCLC.

In a large-scale, contemporary cohort of patients with advanced ALK-positive NSCLC, we evaluated molecular characteristics and their impact on acquired resistance mutations and clinical outcomes. Our findings that certain ALK variants and co-mutations are associated with differential survival and specific TKI-relevant resistance patterns highlight potential molecular underpinnings of the heterogenous response to ALK TKIs and nominate biomarkers that may inform patient selection for first-line and consolidative therapies.

Surgical and survival outcomes of early-onset colorectal cancer patients: a single-centre descriptive Australian study.

Early-onset colorectal cancer (EOCRC) incidence is increasing in Australia. However, no Australian studies have reported on EOCRC patients' surgical management and survival patterns. A retrospective study of 111 EOCRC patients treated at the Royal Prince Alfred Hospital (RPAH), Sydney, Australia between January 2013 and December 2021 was performed. RPAH is a quaternary referral centre for pelvic exenteration (PE) and cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). Most patients had left-sided tumours (76.58%) and stage IV disease at the time of presentation (37.85%). 27.93% of patients underwent either CRS/HIPEC and PE and 72.07% of patients underwent other colorectal resections of which the most common was low anterior resection (19.82%). A stoma was fashioned in 50.54% of patients. Complications occurred in 54.95% of patients of which most were Clavien-Dindo grade II (47.54%). Absolute 1-, 3- and 5-year time intervals were 93.69%, 87.39% and 85.48%. Disease-free and overall survival were poorer in stage IV patients who had PE, followed by CRS/HIPEC then other colorectal resections (P < 0.001 and P = 0.003). Stoma formation, PE and CRS/HIPEC and minor postoperative complications were common in our EOCRC cohort. Despite this, the 5-year absolute survival rate was acceptable. Thus, an aggressive surgical approach in EOCRC patients at a quaternary referral centre may be feasible at the cost of greater postoperative morbidity. This information is imperative in the surgical consent and preoperative counselling of EOCRC patients and highlights the need for further research to assess the postoperative functional outcomes and quality of life of EOCRC patients.