ISSN:8756-0437    

DOI:10.1002/ssu.2980100102

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe advantages and disadvantages of the different methods for calculating survival according to the TNM (Topography, LymphNode, andMetastasis) are described. Methods include the observed, relative, and conditional survival rates. For large cohorts, relative survival calculated by the life table method is most useful. Conditional survival, which requires long‐term follow‐up, is clinically the most informative. In addition, follow‐up methods employed by tumor registries are considered. © 1994 Wiley‐Liss, Inc.This article is a U.S. Government work and, as such is in the public domain in th

ISSN:8756-0437    

DOI:10.1002/ssu.2980100103

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractMortality rates by stage‐at‐diagnosis are not possible from usual mortality data. Normally, mortality data are based solely on information provided on death certificates, and stage‐at‐diagnosis is not generally reported on these documents. However, mortality rates by stage are possible when one can link diagnostic data with mortality data. Population‐based cancer registries collect these types of data routinely in determining the survival of cancers in their registry. Thus, using cancer registry data, mortality rates by stage‐at‐diagnosis can be calculated. We report stage‐specific mortality rates for the Surveillance, Epidemiology, and End Results Program, representing 10% of the cancers in the U.S. for the four sites with the largest mortality rates for females and for males. For an individual site, the stage‐specific mortality rates allow one to determine how the different stages are contributing to the trends in all stage mortality. For example, distant disease mortality is the largest contributor to all stage cancer mortality for female and male lung cancer, female colorectal cancer, ovarian cancer, prostatic cancer and male pancreatic cancer. In contrast, regional disease mortality is the largest contributor to all stage cancer mortality for breast cancer and male colorectal cancer. In addition, localized disease mortality is the second largest contributor to all stage mortality for breast cancer and prostate cancer. © 1994 Wiley‐Liss, Inc.This article is a U.S. Government work, and, as such, is in the public domain in the Un

ISSN:8756-0437    

DOI:10.1002/ssu.2980100104

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe tumor status following treatment is described by the residual tumor (R) classification: R0, no residual tumor; R1, microscopic residual tumor; R2, macroscopic residual tumor. Residual tumor may be found in the area of primary tumor and its regional lymph nodes and/or at distant sites. The R classification reflects the effects of treatment and influences further treatment planning. Furthermore, the R classification is a strong predictor of prognosis. An acceptable long‐term prognosis can be expected only in R0 patients. Although there exist clear correlations between stage and R classification the differences in prognosis of R0 versus R1,2 cannot be explained by differences in stage alone. The prognostic significance of R classification is demonstrated by respective data for non‐small cell lung carcinoma, squamous cell carcinoma of oesophagus, gastric carcinoma, ductal adenocarcinoma of the pancreas, colorectal carcinoma, lung and liver metastases. © 1994 Wiley‐Lis

ISSN:8756-0437    

DOI:10.1002/ssu.2980100105

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractRates calculated from the Surveillance, Epidemiology, and End Results (SEER) Program are used to show variations in lung cancer survival by prognostic factors with an emphasis on the extent of disease and demographic variables. The analysis is based on 52,755 histo‐logically confirmed cases of invasive lung cancer diagnosed from 1983 through 1987 and 51,377 cases diagnosed from 1977 through 1982.Females survived better than males. In general, white patients survived better than blacks. However, if both race and sex are considered together, black females survived better than white males and white females had the highest rates and black males the lowest. Age, however, proved to be the strongest predictor of survival of the demo‐graphic variables. Young females (<45 years) with non‐small cell lung cancer had an 81% 5‐year relative survival rate compared to 44% for those 75 years and over.Survival for small cell lung cancer was lower than that for any other histologic type even when stratified on stage of disease (stages I and II, all stages). Survival for stages III and IV did not vary by histologic type. The histologic grade showed prognostic value only for patients assigned stage I.More detailed extent of disease information was used to show how often specific sites of distant metastases are seen at diagnosis. It also demonstrated the inter‐relationship of the different extent of disease variables and their effect on outcome. © 1994 Wiley‐Liss, Inc.This article is a U.S. Government work, and, as such, is in the public domain in the United State

ISSN:8756-0437    

DOI:10.1002/ssu.2980100106

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe prognostic impact of FIGO stage, histology, histologic grade, age and race in survival for cancers of the female gynecological (cervix, endometrium, ovary, vulva, vagina) were examined using cases obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program that were diagnosed between 1973 and 1987. Utilizing Cox proportional hazards modeling and relative survival rates analysis of 17,119 cases of cervical cancer indicated that the International Federation of Gynecology and Obstetrics (FIGO) stage, histology, histological grade, lymph node status, and age at diagnosis were all independently prognostic. No evidence was found of survival differences between squamous cell carcinoma and adenocarcinoma. Younger women were not found to have a poorer prognosis, survival declined with increased age. Analysis of 41,120 cases of endometrial cancer indicated that FIGO stage, histology, histologic grade, lymph node status, age at diagnostic, and race were all prognostic factors. Clear cell adenocarcinoma, leiomyosarcoma, and mixed mullerian tumors were all found to have poorer prognosis. Analysis of 21,240 cases of ovarian cancer indicated that FIGO stage, histology, histologic grade, lymph node status, age at diagnosis, presence of ascites, and race were all prognostically significant. Analysis of 2,575 cases of vulvar cancer indicated that FIGO stage, histology, histologic grade, age, and race were all prognostically significant. Analysis of 916 cases of vaginal cancer indicated that FIGO stage, histologic grade, lymph node status, and age are all prognostically significant. Additional analysis of the data by combinations of independent prognostic factors indicates that the interaction of factors may be more predictive of outcome than any one factor separately. © 1994 Wiley‐Liss, Inc.This article is a U.S. Government work, and, as such, is in the public domain in the United States of Ameri

ISSN:8756-0437    

DOI:10.1002/ssu.2980100107

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe staging of renal cell carcinoma was initiated in the United States with the systems of Flocks and Robson. The development of the TNM system began in Europe, evolved through several stages and is now being employed throughout the world. The predictive value of the current TNM system is supported by patient survival data. Practitioners treating renal cell carcinoma are encouraged to utilize the TNM classification. © 1994 Wiley‐Liss, I

ISSN:8756-0437    

DOI:10.1002/ssu.2980100108

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe definitive diagnosis of bladder cancer is established at cystoscopic examination and confirmed by means of a transurethral biopsy. A careful bimanual palpation of the bladder under anesthesia is an integral part of the initial assessment of each patient. The most important part of the assessment of patients with bladder cancer is a thorough pathologic examination of the biopsy material establishing the histo‐logic type of tumor, histologic grade, tumor configuration, depth of invasion of the bladder wall, and depth of the bladder wall available for assessment. If possible, the size of the tumor and the presence of associated carcinoma in situ should also be reported. Imaging studies play a smaller role in the clinical staging of bladder cancer. However, when initial staging procedures point to invasion of the muscularis propria, chest X‐ray, bone scan, and computed tomography scan of the abdomen and pelvis may provide valuable information about possible metastases. Whereas the clinical staging is essential to select and evaluate therapy, the pathologic stage (pTNM) provides the most precise data with which to estimate prognosis and calculate end results. The pathologic assessment entails resection of the primary tumor or a biopsy adequate to evaluate the highest pT category, removal of lymph nodes adequate to validate the absence of regional lymph node metastasis, as well as biopsy and microscopic examination for assessment of distant metastases. Although numerous factors have an impact on the behaviour of the malignancy, in bladder cancer the anatomic extent of disease reflected in the current staging classification remains the most powerful indicator of outcome. © 1994 Wiley‐Lis

ISSN:8756-0437    

DOI:10.1002/ssu.2980100109

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe clinical and pathologic staging of prostate cancer involves determination of the anatomic extent and burden of tumor based on the best available data. Two major classification schemes are currently used: the modified American system and the TNM system [primary tumor (T), regional lymph node (N), and metastases (M)]. Both systems stratify patients according to the method of tumor detection, separating nonpalpable “incidental” prostate cancers detected during transurethral resection for clinically benign prostatic hyperplasia (BPH) and palpable cancers detected by digital rectal examination. These staging systems also recognize nonpalpable tumors detected by an elevated serum prostate‐specific antigen (PSA) level or an abnormal transrectal ultrasound image. Current staging is limited by a significant level of clinical understaging (up to 59%, in our experience) and over‐staging (up to 5%) according to comparison with pathologic examination of resected specimens. Proposed improvements in staging include preoperative systematic sextant biopsies to assess tumor volume, volume‐based prognostic index, and a multiple prognostic index. In this report, we evaluate the current aspects of clinical and pathologic staging of prostate cancer with emphasis on the early stages in which there is the greatest chance of cure. © 1994 Wiley

ISSN:8756-0437    

DOI:10.1002/ssu.2980100110

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe use of artificial neural networks in biological and medical research has increased tremendously in the last few years. Artificial neural networks are being used in cancer research for image processing, the analysis of laboratory data for breast cancer diagnosis, the discovery of chemotherapeutic agents, and for cancer outcome prediction. A neural network generalizes from the input data to patterns inherent in the data, and it uses these patterns to make predictions or to classify. This paper explains how neural networks work, and it shows that a neural network is more accurate at predicting breast cancer patient outcome than the current staging system. © 1994 Wiley‐Liss, I

ISSN:8756-0437    

DOI:10.1002/ssu.2980100111

出版商:John Wiley&Sons, Inc.    

年代:1994

数据来源: WILEY