Pan-metastatic cancer analysis of prognostic factors and a prognosis-based metastatic cancer classification system

Zhang, Chao; Xu, Ge‐Liang; Xu, Yao; Wu, Haixiao; Guo, Xu; Mao, Min; Baklaushev, Vladimir P.; Чехонин, В. П.; Peltzer, Karl; Bai, Yuzhen; Wang, Guowen; Ma, Wenjuan; Wang, Xin

doi:10.18632/aging.103467

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…They suggested the surgery was negatively associated with all causes of death risk for metastatic rectal cancers after adjusting for age, sex, and other clinical characteristics. 22 Consistent with these studies, our study also confirmed negative associations between surgery on the primary site and all causes of mortality, even in patients with distant metastasis and patients with advanced age (>80 years). We also suggest the surgery could not prolong the survival in patients with four organ metastasis.…”

Section: Discussionsupporting

confidence: 91%

Not all Rectal Cancer Patients Could Benefit From the Surgery on the Primary Site

Zhou

Xia

et al. 2023

Cancer Control

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Aim Previous studies have provided evidence that primary site surgery can improve the prognosis of rectal cancer patients, even in those with advanced age and distant metastasis, though results have been inconsistent. The current study aims to determine if all rectal cancer patients are likely to benefit from surgery in terms of overall survival. Methods This study examined the impact of primary site surgery on the prognosis of rectal cancer patients diagnosed between 2010 and 2019 using multivariable Cox regression analysis. The study also stratified patients by age group, M stage, chemotherapy, radiotherapy, and number of distant metastatic organs. The propensity score matching method was used to balance observed covariates between patients who received and did not receive surgery. The Kaplan–Meier method was used to analyze the data, and the log-rank test was used to determine differences between patients who did and did not undergo surgery. Results The study included 76,941 rectal cancer patients, with a median survival of 81.0 months (95% CI: 79.2–82.8 months). Of these patients, 52,360 (68.1%) received primary site surgery, and they tended to be younger, have higher differentiated grade, earlier T, N, M stage, and lower rates of bone, brain, lung, and liver metastasis, chemotherapy, and radiotherapy than those without surgery. Multivariable Cox regression analysis revealed that surgery had a protective effect on the prognosis of rectal cancer patients, including those with advanced age, distant metastasis, and multiple organ metastasis, but not in patients with four organ metastases. The results were also confirmed using propensity score matching. Conclusion Not all rectal cancer patients could benefit from the surgery on the primary site, especially the patients with more than four distant metastases. The results could help the clinicians to tailor targeted treatment regimens and provide a guideline for making surgical decisions.

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Section: Discussionsupporting

confidence: 91%

Not all Rectal Cancer Patients Could Benefit From the Surgery on the Primary Site

Zhou

Xia

et al. 2023

Cancer Control

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“…Zhang and colleagues conducted a pan-cancer analysis of the prognostic factors for metastatic cancer. They suggested the surgery was negatively associated with all causes of death risk for metastatic rectal cancers after adjusting for age, sex, and other clinical characteristics [20]. Consistent with these studies, our study also con rmed negative associations between surgery on the primary site and all causes of mortality, even in patients with distant metastasis and patients with advanced age (> 80 years).…”

Section: Discussionsupporting

confidence: 91%

Not all rectal cancer patients could benefit from the surgery on the primary site

Zhou

Xia

et al. 2022

Preprint

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Purpose Pieces of evidence showed the surgery on the primary site could improve the prognosis of rectal cancer patients, but the results were inconsistent. The present study investigates whether all patients could benefit from the surgery. Methods The rectal cancer patients diagnosed between 2010 and 2019 in the Surveillance, Epidemiology, and End Results cohort were included. Multivariable Cox regression was utilized to investigate the effect of the primary site surgery on the prognosis in total patients and stratified by the age, M stage and the number of distant metastatic organs. The propensity score matching (PSM) method was also used to balance observed covariates and Kaplan-Meier method with the log-rank test was used to exam the differences in the prognosis. Results A total of 76,941 rectal cancer patients were included and about 68.1% received surgery. The patients with surgery have a relatively lower proportion of advanced age, higher differentiated grade, T stage, N stage, M stage, and bone, brain, lung, and liver metastasis than patients without surgery. Multivariable Cox regression showed a protective effect of the surgery on the prognosis, even in patients with advanced age, distant metastasis, and multiple organ metastasis. However, no association was found in patients with four organ metastases. The PSM also confirmed the results mentioned above. Conclusion Not all rectal cancer patients could benefit from the surgery, especially the patients with four organ distant metastases. The results could help the clinicians to tailor targeted treatment regimens and provide a guideline for making surgical decisions.

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“…In the current literature, hierarchical clustering has been also used to classify various patients with pan-metastatic cancers. Zhang and his teammates [ 29 ] used hierarchical clustering analysis to construct a classification system based on survival and prognostic factors, thus dividing stage IV metastatic patients into three categories. This approach helps provide a novel strategy for guiding the prediction of survival and personalized treatment for stage IV metastatic patients.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and risk factors of bone metastasis and the development of bone metastatic prognostic classification system: a pan-cancer population study

Hu,

Yang,

et al. 2023

Aging

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Background: The prevalence of bone metastasis (BM) varies among primary cancer patients, and it has a significant impact on prognosis. However, there is a lack of research in this area. This study aims to explore the clinical characteristics, prevalence, and risk factors, and to establish a prognostic classification system for pan-cancer patients with BM. Methods: The data obtained from the Surveillance, Epidemiology and End Results database were investigated. The prevalence and prognosis of patients with BM were analyzed. Hierarchical clustering was used to develop a prognostic classification system. Results: From 2010 to 2019, the prevalence of BM has increased by 41.43%. BM most commonly occurs in cancers that originate in the adrenal gland, lung and bronchus and overlapping lesion of digestive systems. Negative prognostic factors included older age, male sex, poorer grade, unmarried status, low income, non-metropolitan living, advanced tumor stages, previous chemotherapy, and synchronous liver, lung, and brain metastasis. Three categories with significantly different survival time were identified in the classification system. Conclusions: The clinical features, prevalence, risk factors, and prognostic factors in pan-cancer patients with BM were investigated. A prognostic classification system was developed to provide survival information and aid physicians in selecting personalized treatment plans for patients with BM.

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Pan-metastatic cancer analysis of prognostic factors and a prognosis-based metastatic cancer classification system

Cited by 4 publications

References 27 publications

Not all Rectal Cancer Patients Could Benefit From the Surgery on the Primary Site

Not all Rectal Cancer Patients Could Benefit From the Surgery on the Primary Site

Not all rectal cancer patients could benefit from the surgery on the primary site

Prevalence and risk factors of bone metastasis and the development of bone metastatic prognostic classification system: a pan-cancer population study

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