• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1533-1537
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• 2012

In general, breast cancer is the most common malignancy among women in developed as well as some developing countries, often being the second leading cause of cancer mortality after lung cancer. Using a parametric log-logistic model to consider the effects of prognostic factors, the present study focused on the 5-year survival of women with the diagnosis of breast cancer in Southern Iran. A total of 1,148 women who were diagnosed with primary invasive breast cancer from January 2001 to January 2005 were included and divided into three prognosis groups: poor, medium, and good. The survival times as well as the hazard rates of the three different groups were compared. The log-logistic model was employed as the best parametric model which could explain survival times. The hazard rates of the poor and the medium prognosis groups were respectively 13 and 3 times greater than in the good prognosis group. Also, the difference between the overall survival rates of the poor and the medium prognosis groups was highly significant in comparison to the good prognosis group. Use of the parametric log-logistic model - also a proportional odds model - allowed assessment of the natural process of the disease based on hazard and identification of trends.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6253-6255
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• 2014

Background: Colorectal cancer (CRC) is considered to be a main cause of malignancy-related death in the world, being commonly diagnosed in both men and women. It is the third leading cause of cancer dependent death in the world and there are one million new cases diagnosed per year. In Iran the incidence of colorectal cancer has increased during the last 25 years and it is the fifth cause of cancer in men and the third in women. Materials and Methods: In this article we analyzed the survival of 475 colorectal patients of Taleghani hospital in Tehran with the semi-parametric competing-risks model. Results: There were 55% male cases and at the time of the diagnosis most of the patients were between 48 and 67years old. The probability of a patient death from colorectal cancer with survival of more than 25 years was about 0.4. Body mass index, height, tumour site and gender had no influence. Conclusions: According to these data and by using semi-parametric competing-risks method, we found out that only age at diagnosis has a significant effect on these patient survival time.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.89-93
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• 2016

Background: Limited data are available regarding the impact of time duration between chemoradiation (CRT) and surgery on pathological complete response (PCR). A PCR translates into better overall and disease free survival. The objective of this study was to determine effect of time duration on outcome after preoperative CRT in rectal cancer. Materials and Methods: A retrospective review of patients undergoing operations for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided in two groups: Group 1 underwent surgery in ${\leq}8weeks$ post neoadjuvant CRT and Group 2 after 8 weeks. Patient characteristics, surgical procedure, histopathological details and number of loco-regional and distant failures were compared. Expected 5 year overall survival and disease free survival was calculated using Kaplan Meier curves and significance was determined using the log rank test. Results: There were 66 patients in group 1 and 93 in group 2. No significant difference in PCR was observed between the two. However, estimated 5 year DFS was significantly higher in Group 1 (66.7%) as compared to Group 2 (53.8%) (P=0.04). Estimated overall 5 year overall survival was not significantly different at 68.2% versus 54.3% (P= 0.09). Conclusions: Delaying surgery more than 8 weeks after preoperative CRT does not impact for PCR in rectal cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6339-6342
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• 2014

Background: The incidence of rectal cancer is increasing in younger age groups. Limited data is available regarding survival outcome in younger patients with conflicting results from western world. The goal of this study was to determine survival in patients with rectal cancer <30 years of age and compare it with their older counterparts in the Pakistani population. Materials and Methods: A retrospective chart review of patients operated for rectal adenocarcinoma between January 2005 and December 2010 was performed. Patients were divided into two groups, Group 1 aged ${\leq}30years$ and Group 2 aged >30years. Patient characteristics, surgical procedure, histopathological details and number of loco-regional and distant failures were compared. Expected 5 year survival was calculated using Kaplan Meier curves and significance was determined using the Log rank test. Results: There were 38 patients in group 1 and 144 in group 2. A significantly high number of younger patients presented with poorly differentiated histology (44.7% vs 9.7%) (p=0.0001) and advanced pathological stage (63.1% vs 38.1%) (p=0.04). Predicted overall 5 year survival was 38% versus 57% in groups I and II, respectively (p=0.05). Disease free survival was 37% versus 52% and was significantly different (p=0.007). Conclusions: Early onset rectal cancer is associated with poor pathological features and a worse outcome in Pakistani population.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8429-8433
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• 2014

Circulating tumor cells (CTCs) are believed to be particularly important and a reliable marker of malignancy. However, the prognostic significance of CTCs detected in patients with small cell lung cancer (SCLC) is still unclear. We therefore aimed to assess the prognostic relevance of CTCs using a meta-analysis. We searched PubMed for relevant studies and statistical analyses were conducted to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) using fixed or random-effect models according to the heterogeneity of included studies. A total of 7 papers covering 440 SCLC patients were combined in the final analysis. The meta-analysis revealed that CTCs were significantly associated with shorter overall survival (HR=1.9; 95%CI: 1.19-3.04; Z=2.67; P<0.0001) and progression-free survival (HR=2.6; 95%CI: 1.9-3.54; Z=6.04; P<0.0001). The results thus suggest that the presence of CTCs indicates a poor prognosis in patients with SCLC. Further well-designed prospective studies are required to explore the clinical applications of CTCs in SCLC.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7295-7302
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• 2015

Background: Lung cancer has been a major health problem in developed countries for several decades, and has emerged recently as the leading cause of cancer death in many developing countries. The incidence of lung cancer appears to be increasing more rapidly in rural than in urban areas of China. This paper presents the trends of lung cancer incidence and survival derived from a 40-year population-based cancer monitoring program in a rural area, Qidong, China. Materials and Methods: The Qidong cancer registration data of 1972-2011 were used to calculate the crude rate, age-standardized rate by Chinese population (CASR) and by world population (WASR), birth cohort rates, and other descriptive features. Active and passive methods were used to construct the data set, with a deadline of the latest follow-up of April 30, 2012. Results: The total number of lung cancer cases was 15,340, accounting for 16.5% of all sites combined. The crude incidence rate, CASR and WASR of this cancer were 34.1, 15.7 and 25.4 per 100,000, respectively. Males had higher crude rates than females (49.7 vs 19.0). Rapidly increasing trends were found in annual percent change resulting in lung cancer being a number one cancer site after year 2010 in Qidong. Birth cohort analysis showed incidence rates have increased for all age groups over 24 years old. The 5 year observed survival rates were 3.55% in 1973-1977, 3.92 in 1983-1987, 3.69% in 1993-1997, and 6.32% in 2003-2007. Males experienced poorer survival than did females. Conclusions: Lung cancer has become a major cancer-related health problem in this rural area. The rapid increases in incidence likely result from an increased cigarette smoking rate and evolving environmental risk factors. Lung cancer survival, while showing some improvement in prognosis, still remains well below that observed in the developed areas of the world.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.11
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• pp.4691-4698
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• 2015

Background: The tumor suppressor phosphatase and tensin homolog (PTEN) is an important negative regulator of cell-survival signaling. However, available results for the prognostic value of PTEN expression in patients with cancer remain controversial. Therefore, a meta-analysis of published studies investigating this issue was performed. Materials and Methods: A literature search via PubMed and EMBASE databases was conducted. Statistical analysis was performed by using the STATA 12.0 (STATA Corp., College, TX). Data from eligible studies were extracted and included into the meta-analysis using a random effects model. Results: A total of 3,810 patients from 27 studies were included in the meta-analysis, 22 investigating the relationship between PTEN expression and overall survival (OS) using univariate analysis, and nine with multivariate analysis. The pooled hazard ratio (HR) for OS was 1.64 (95% confidence interval (CI): 1.32-2.05) by univariate analysis and 1.56 (95% CI: 1.20-2.03) by multivariate analysis. In addition, eight papers including two disease-free-survival analyses (DFSs), four relapse-free-survival analyses (RFSs), three progression-free-survival analyses (PFSs) and one metastasis-free-survival analysis (MFS) reported the effect of PTEN on survival. The results showed that loss of PTEN expression was significant correlated with poor prognosis, with a combined HR of 1.74 (95% CI: 1.24-2.44). Furthermore, in the stratified analysis by the year of publication, ethnicity, cancer type, method, cut-off value, median follow-up time and neoadjuvant therapy in which the study was conducted, we found that the ethnicity, cancer type, method, median follow-up time and neoadjuvant therapy are associated with prognosis. Conclusions: Our study shows that negative or loss of expression of PTEN is associated with worse prognosis in patients with cancer. However, adequately designed prospective studies need to be performed for confirmation.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.136-143
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• 2001

Purpose: The prognosis for gastric cancer with peritoneal seeding is very poor, and the role of surgical intervention is limited. We evaluated the effect of radical removal of primary and metastatic lesions on survival in gastric cancer with peritoneal seeding. Materials and Methods: From May 1989 to March 1999 at Kosin University Gospel Hospital, 115 patients revealed gastric cancer with peritoneal seeding but without liver or lung metastasis and without follow-up loss. The study group included 86 patients who underwent surgery for radical removal of primary gastric and metastatic peritoneal lesions. The control group included 29 patients who experienced incomplete removal of primary or metastatic lesions. Both groups received intraoperative intraperitoneal chemotherapy using mytomycin or cisplatin, and 25 patients underwent postoperative intravenous chemotherapy. Results: The median survival times in the study and the control groups were 13 months and 4 months, respectively (p<0.0001). The 1-year, 2-year, and 5-year survival rates were, respectively, $50.6\%,\;18.1\%$, and $11.3\%$ in the study group and $14.8\%,\;3.7\%$ and $0\%$ in the control group (p<0.0001). In the study group, neither postoperative intravenous chemotherapy nor microscopic invasion of the resection margin had any effect on survival, but intraoperative intraperitoneal chemotherapy and degree of peri-toneal seeding, especially the amount of peritoneal seeding, had an effect on survival. In the control group, neither intraperitoneal nor intravenous chemotherapy had any effect on survival, but resection of the primary gastric lesion improved survival. Conclusion: Radical removal of primary gastric and metastatic peritoneal lesions improved the survival rate for gastric cancer with peritoneal seeding. However, a randomized prospective study is needed to correctly evaluate the effect of intraperitoneal or intravenous chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1763-1766
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• 2014

Background: The influence of season of diagnosis on cancer survival has been an interesting issue for many years. Most studies have shown a possible association between seasonality and survival in some cancers. We aimed to investigate whether there is an association between season of diagnosis and survival in patients with gastric cancer. Materials and Methods: We reviewed retrospectively the files of 279 histologically proven gastric cancer patients. According to diagnosis date, the patients were grouped into 4 seasons of diagnosis groups, spring, summer, autumn, and winter. Results: There was no significant differences when the overall survival rates of the patients were compared according to the patients' season of diagnosis (p: 0.871). Median overall survival rates were 22.0 (14.5-29.5) months for the patients who were diagnosed in spring, 24.0 (12.4-35.6) for summer, 18.0 (9.96-26.0) for autumn and 21.0 (16.3-25.7) for winter. Median disease-free survival rates were 66.0 (44.1-68.1) months for the patients who were diagnosed in spring, 28.0 (17.0-39.0) for summer, 22.0 (0-46.4) for autumn and 23.0 (17.5-28.5) for winter. While the rate was best for the patients diagnosed in spring the differences were not statistically significant (p= 0.382). Conclusions: On the basis of the above results the season was not suggested as contributing to prognosis in gastric cancer cases in Kayseri, Turkey.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4661-4666
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• 2013

Background: The wide spectrum of clinical features in advanced stages of non-small cell lung cancer (NSCLC) probably contributes to disparities in outcomes because of different prognostic variables significant for stage IIIB/IV patients. Hence the aim of this study was to check for favorable response of patients to various chemotherapeutic combinations with respect to patient survival in stage IIIB and stage IV NSCLC disease. We selected those patients for our study who were receiving treatment with paclitaxel, gemcitabine or etoposide in combination with platinum based drugs. Materials and Methods: Seventy-two patients who visited the hospital from June 2009 to November 2012 with confirmed diagnosis of lung cancer were included, and data were collected for follow up and classified according to treatment received with respect to patients' regimen and response, and overall survival. This study analyzed tumor variables that were associated with clinical outcome in advanced NSCLC patients who were undergoing first-line chemotherapy for stage IIIB/IV NSCLC. Results: Comparative data on various parameters like age, gender, stage, histology, site of disease, metastatic site and chemo-regimens was analyzed; these parameters predicted variable significant improvement for overall survival ($p{\geq}0.05$). One and two year survival rates were 20.8% and 15.3%. Conclusions: In this study we found slight improvement in survival rates in NSCLC and clinical outcomes with one combination (carboplatin+paclitaxel). Overall there were only marginal differences in survival rates for other chemo-regimens evaluated in this study.