Conditional Survival after Surgical Resection of Gastric Cancer: A Multi-Institutional Analysis of the US Gastric Cancer Collaborative

Kim, Yuhree; Ejaz, Aslam; Spolverato, Gaya; Squires, Malcolm H.; Poultsides, George A.; Fields, Ryan C.; Bloomston, Mark; Weber, Sharon M.; Votanopoulos, Konstantinos I.; Acher, Alexandra W.; Jin, Linda X.; Hawkins, William G.; Schmidt, Carl; Kooby, David A.; Worhunsky, David J.; Saunders, Neil; Cho, Clifford S.; Levine, Edward A.; Maithel, Shishir K.; Pawlik, Timothy M.

doi:10.1245/s10434-014-4116-5

Cited by 64 publications

(81 citation statements)

References 35 publications

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“…one is limited in using previous literature values to calculate conditional survival because it requires 5 additional years of follow-up and survival results. the trends are also not surprising when compared with those of other cancer sites, such as colon, 7 rectum, 8 colorectal, 15 stomach, 11,16,17 liver, 18 head and neck, 19 ovary, 10 thymus, 20 thyroid, 21 lial carcinoma. 26,27 all of these solid tumors show more dramatic improvements in prognosis in more advanced stages of cancer.…”

Section: Discussionmentioning

confidence: 87%

Conditional Survival in Anal Carcinoma Using the National Population-Based Survey of Epidemiology and End Results Database (1988–2012)

Kim

Choi

et al. 2016

Diseases of the Colon &Amp; Rectum

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Section: Discussionmentioning

confidence: 87%

Conditional Survival in Anal Carcinoma Using the National Population-Based Survey of Epidemiology and End Results Database (1988–2012)

Kim

Choi

et al. 2016

Diseases of the Colon &Amp; Rectum

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“…1 Despite potential improvements in treatment, the prognosis of gastric cancer remains poor, particularly in China and Western countries. 2–4 Surgical resection remains the most effective therapy for potentially curable gastric cancer. 5 However, gastrectomy is associated with high complications rates and operative mortality.…”

Section: Introductionmentioning

confidence: 99%

“…3,6 In addition, a large proportion of patients died within 5 years after a potentially curative (R0) resection. 2–4 Therefore, the prognostic assessment of patients with gastric cancer after radical surgery is critical for guiding therapeutic schedule and follow-up strategies.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

et al. 2016

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Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer.From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed.A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P < 0.001), but not for total complications. However, sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P < 0.001) and disease-free survival (HR = 1.620, P < 0.001). Under the adjusted tumor-node-metastasis (TNM) stage, sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I.Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I.

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“…The non-parametric or semi-parametric forms, based on Kaplan-Meier or Cox methods, have been increasingly applied in oncology over the last decade. 27–29 They have been used to predict survival beyond a given earlier time point, e.g. survival to five years, given survival to one year after cancer resection.…”

Section: Discussionmentioning

confidence: 99%

The Optimal Timing of Stage 2 Palliation for Hypoplastic Left Heart Syndrome

et al. 2017

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Background In infants requiring three-stage single ventricle palliation for hypoplastic left heart syndrome, attrition after the Norwood procedure remains significant. The effect of the timing of stage-2-palliation (S2P), a physician-modifiable factor, on long term survival is not well understood. We hypothesized that an optimal interval between the Norwood and S2P that both minimizes pre-S2P attrition and maximizes post-S2P survival exists and is associated with individual patient characteristics. Methods The NIH/NHLBI Pediatric Heart Network Single Ventricle Reconstruction Trial public dataset was used. Transplant-free survival (TFS) was modeled from (1) Norwood to S2P and (2) S2P to three years, using parametric hazard analysis. Factors associated with death or heart transplantation were determined for each interval. To account for staged procedures, risk-adjusted, three-year, post-Norwood TFS (the probability of TFS at three years given survival to S2P) was calculated using parametric conditional survival analysis. TFS from the Norwood to S2P was first predicted. TFS after S2P to three years was then predicted and adjusted for attrition before S2P by multiplying by the estimate of TFS to S2P. The optimal timing of S2P was determined by generating nomograms of risk-adjusted, three-year, post-Norwood, TFS versus the interval from the Norwood to S2P. Results Of 547 included patients, 399 survived to S2P (73%). Of the survivors to S2P, 349 (87%) survived to three-year follow-up. The median interval from the Norwood to S2P was 5.1 (IQR 4.1–6.0) months. The risk-adjusted, three-year, TFS was 68±7%. A Norwood-S2P interval of three to six months was associated with greatest three-year TFS overall and in patients with few risk factors. In patients with multiple risk factors, TFS was severely compromised, regardless of the timing of S2P and most severely when S2P was performed early. No difference in the optimal timing of S2P existed when stratified by shunt type. Conclusions In infants with few risk factors, progressing to S2P at three to six months after the Norwood procedure was associated with maximal TFS. Early S2P did not rescue patients with greater risk factor burdens. Instead, referral for heart transplantation may offer their best chance at long term survival. ClinicalTrials.gov number: NCT00115934.

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Conditional Survival after Surgical Resection of Gastric Cancer: A Multi-Institutional Analysis of the US Gastric Cancer Collaborative

Cited by 64 publications

References 35 publications

Conditional Survival in Anal Carcinoma Using the National Population-Based Survey of Epidemiology and End Results Database (1988–2012)

Conditional Survival in Anal Carcinoma Using the National Population-Based Survey of Epidemiology and End Results Database (1988–2012)

Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

The Optimal Timing of Stage 2 Palliation for Hypoplastic Left Heart Syndrome

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