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Prognostic impact of tumor size on patients with neuroblastoma in a SEER‐based study
Objective The prognostic value of tumor size in neuroblastoma (NB) patients has not been fully evaluated. Our purpose is to elucidate the prognostic significance of tumor size in surgery performed on neuroblastoma patients. Methods Neuroblastoma patients diagnosed from 2004 to 2015 were selected fro...
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| Published in: | Cancer medicine (Malden, MA) MA), 2022-07, Vol.11 (14), p.2779-2789 |
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| creator | Wang, Jin‐Xia Cao, Zi‐Yang Wang, Chun‐Xia Zhang, Hong‐Yang Fan, Fei‐Long Zhang, Jun He, Xiao‐Yan Liu, Nan‐Jing Liu, Jiang‐Bin Zou, Lin |
| description | Objective
The prognostic value of tumor size in neuroblastoma (NB) patients has not been fully evaluated. Our purpose is to elucidate the prognostic significance of tumor size in surgery performed on neuroblastoma patients.
Methods
Neuroblastoma patients diagnosed from 2004 to 2015 were selected from the Surveillance, Epidemiology, and End Results Program (SEER) for the study. Univariate and multivariate Cox proportional hazard regression models were used to identify risk factors and the independent prognostic influences of tumor size on NB patients. Overall survival (OS) was analyzed through univariate Cox regression analysis. To determine the optimal cutoff value of tumor size, we first divided the cohort into three groups (≤5 cm, 5–10 cm, >10 cm). Subsequently, the patients were divided into two groups repeatedly, with tumor size at 1 cm intervals. The cutoff value that maximized prognostic outcome difference was selected. Furthermore, we performed the Kaplan–Meier methods to visually present differences in prognosis between the optimal tumor size cutoff value in different subgroups.
Results
A total of 591 NB patients who met the inclusion criteria were selected from the SEER database in this study. Cox analysis showed that age >1 year (HR = 2.42, p |
| doi_str_mv | 10.1002/cam4.4653 |
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The prognostic value of tumor size in neuroblastoma (NB) patients has not been fully evaluated. Our purpose is to elucidate the prognostic significance of tumor size in surgery performed on neuroblastoma patients.
Methods
Neuroblastoma patients diagnosed from 2004 to 2015 were selected from the Surveillance, Epidemiology, and End Results Program (SEER) for the study. Univariate and multivariate Cox proportional hazard regression models were used to identify risk factors and the independent prognostic influences of tumor size on NB patients. Overall survival (OS) was analyzed through univariate Cox regression analysis. To determine the optimal cutoff value of tumor size, we first divided the cohort into three groups (≤5 cm, 5–10 cm, >10 cm). Subsequently, the patients were divided into two groups repeatedly, with tumor size at 1 cm intervals. The cutoff value that maximized prognostic outcome difference was selected. Furthermore, we performed the Kaplan–Meier methods to visually present differences in prognosis between the optimal tumor size cutoff value in different subgroups.
Results
A total of 591 NB patients who met the inclusion criteria were selected from the SEER database in this study. Cox analysis showed that age >1 year (HR = 2.42, p < 0.0001), originate from adrenal site (HR = 1.7, p = 0.014), distant stage (HR = 6.4, p < 0.0001), undifferentiated grade (HR = 1.94, p = 0.002), and large tumor size (HR = 1.5, p < 0.0001) independently predicted poor prognosis. For tumor size, there were significant differences in tumor size distribution in different ages, tumor grade, disease stage, and primary site subgroup but not in sex, race, and histology subgroup. Furthermore, both univariate (HR = 4.96, 95% CI 2.31–10.63, p < 0.0001) and multivariable analysis (HR = 2.8, 95% CI 1.29–6.08, p < 0.0001) indicated the optimal cutoff value of tumor size was 4 cm for overall survival of NB patients. Using a 4 cm of tumor size cutoff in subgroups, we found that it can identify poor prognosis patients whatever their age or primary site. Interestingly, tumor size of 4 cm cutoff can only identify unfavorable NB patients with diagnosis at distant‐stage disease, or differentiated grade tumor, but not with regional and local or undifferentiated tumor.
Conclusions
Tumor size is first to be recognized as a key prognostic factor of neuroblastoma patients and a cutoff value >4 cm might predict poor prognosis, which should be included in the evaluation of prognostic factors for NB.
we found that tumor size could independently predict prognosis in NB patients, and a single cut‐off at 4 cm that maximized prognostic discrimination of NB children was essential for identify the poor prognosis subgroup.</description><identifier>ISSN: 2045-7634</identifier><identifier>EISSN: 2045-7634</identifier><identifier>DOI: 10.1002/cam4.4653</identifier><identifier>PMID: 35315591</identifier><language>eng</language><publisher>United States: John Wiley & Sons, Inc</publisher><subject>Age ; Cancer ; Confidence intervals ; Epidemiology ; Histology ; Medical prognosis ; Neuroblastoma ; Population ; Prognosis ; Regression analysis ; Risk factors ; SEER ; Size distribution ; Statistical analysis ; Surgery ; Survival ; survival analysis ; tumor size ; Tumors</subject><ispartof>Cancer medicine (Malden, MA), 2022-07, Vol.11 (14), p.2779-2789</ispartof><rights>2022 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.</rights><rights>2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5763-79bca0ef1ffdf17008a57c6cf470a1288313023880ef1e601d49208f6aec0e733</citedby><cites>FETCH-LOGICAL-c5763-79bca0ef1ffdf17008a57c6cf470a1288313023880ef1e601d49208f6aec0e733</cites><orcidid>0000-0003-2772-0393 ; 0000-0003-0851-1203</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2822697117/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2822697117?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11560,25751,27922,27923,37010,37011,44588,46050,46474,53789,53791,74896</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35315591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, Jin‐Xia</creatorcontrib><creatorcontrib>Cao, Zi‐Yang</creatorcontrib><creatorcontrib>Wang, Chun‐Xia</creatorcontrib><creatorcontrib>Zhang, Hong‐Yang</creatorcontrib><creatorcontrib>Fan, Fei‐Long</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>He, Xiao‐Yan</creatorcontrib><creatorcontrib>Liu, Nan‐Jing</creatorcontrib><creatorcontrib>Liu, Jiang‐Bin</creatorcontrib><creatorcontrib>Zou, Lin</creatorcontrib><title>Prognostic impact of tumor size on patients with neuroblastoma in a SEER‐based study</title><title>Cancer medicine (Malden, MA)</title><addtitle>Cancer Med</addtitle><description>Objective
The prognostic value of tumor size in neuroblastoma (NB) patients has not been fully evaluated. Our purpose is to elucidate the prognostic significance of tumor size in surgery performed on neuroblastoma patients.
Methods
Neuroblastoma patients diagnosed from 2004 to 2015 were selected from the Surveillance, Epidemiology, and End Results Program (SEER) for the study. Univariate and multivariate Cox proportional hazard regression models were used to identify risk factors and the independent prognostic influences of tumor size on NB patients. Overall survival (OS) was analyzed through univariate Cox regression analysis. To determine the optimal cutoff value of tumor size, we first divided the cohort into three groups (≤5 cm, 5–10 cm, >10 cm). Subsequently, the patients were divided into two groups repeatedly, with tumor size at 1 cm intervals. The cutoff value that maximized prognostic outcome difference was selected. Furthermore, we performed the Kaplan–Meier methods to visually present differences in prognosis between the optimal tumor size cutoff value in different subgroups.
Results
A total of 591 NB patients who met the inclusion criteria were selected from the SEER database in this study. Cox analysis showed that age >1 year (HR = 2.42, p < 0.0001), originate from adrenal site (HR = 1.7, p = 0.014), distant stage (HR = 6.4, p < 0.0001), undifferentiated grade (HR = 1.94, p = 0.002), and large tumor size (HR = 1.5, p < 0.0001) independently predicted poor prognosis. For tumor size, there were significant differences in tumor size distribution in different ages, tumor grade, disease stage, and primary site subgroup but not in sex, race, and histology subgroup. Furthermore, both univariate (HR = 4.96, 95% CI 2.31–10.63, p < 0.0001) and multivariable analysis (HR = 2.8, 95% CI 1.29–6.08, p < 0.0001) indicated the optimal cutoff value of tumor size was 4 cm for overall survival of NB patients. Using a 4 cm of tumor size cutoff in subgroups, we found that it can identify poor prognosis patients whatever their age or primary site. Interestingly, tumor size of 4 cm cutoff can only identify unfavorable NB patients with diagnosis at distant‐stage disease, or differentiated grade tumor, but not with regional and local or undifferentiated tumor.
Conclusions
Tumor size is first to be recognized as a key prognostic factor of neuroblastoma patients and a cutoff value >4 cm might predict poor prognosis, which should be included in the evaluation of prognostic factors for NB.
we found that tumor size could independently predict prognosis in NB patients, and a single cut‐off at 4 cm that maximized prognostic discrimination of NB children was essential for identify the poor prognosis subgroup.</description><subject>Age</subject><subject>Cancer</subject><subject>Confidence intervals</subject><subject>Epidemiology</subject><subject>Histology</subject><subject>Medical prognosis</subject><subject>Neuroblastoma</subject><subject>Population</subject><subject>Prognosis</subject><subject>Regression analysis</subject><subject>Risk factors</subject><subject>SEER</subject><subject>Size distribution</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Survival</subject><subject>survival analysis</subject><subject>tumor size</subject><subject>Tumors</subject><issn>2045-7634</issn><issn>2045-7634</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kd1qFDEYhgdRbKk98AYk4IkebJv_ZE6EsqxaqCj-nYZvMsk2y8xkTWYs65GX4DV6JWa6tbSCOUlIHp68yVtVTwk-IRjTUws9P-FSsAfVIcVcLJRk_OGd9UF1nPMGl6EwlYo8rg6YYESImhxWXz-kuB5iHoNFod-CHVH0aJz6mFAOPxyKA9rCGNwwZnQVxks0uCnFpoM8xh5QGBCgT6vVx98_fzWQXYvyOLW7J9UjD112xzfzUfXl9erz8u3i4v2b8-XZxcKKEm2h6sYCdp5433qiMNYglJXWc4WBUK0ZYZgyrWfGSUxaXlOsvQRnsVOMHVXne28bYWO2KfSQdiZCMNcbMa0NpPK2zhkuW8Vx0wrJFFeCgqektdh63XDqalFcr_au7dT0rrXlyQm6e9L7J0O4NOv43dQlI5VzmBc3ghS_TS6Ppg_Zuq6DwcUpGyo50ZJzNt_1_B90E6c0lK8yVBdZrQhRhXq5p2yKOSfnb8MQbObyzVy-mcsv7LO76W_Jv1UX4HQPXIXO7f5vMsuzd_xa-Qdzt7ig</recordid><startdate>202207</startdate><enddate>202207</enddate><creator>Wang, Jin‐Xia</creator><creator>Cao, Zi‐Yang</creator><creator>Wang, Chun‐Xia</creator><creator>Zhang, Hong‐Yang</creator><creator>Fan, Fei‐Long</creator><creator>Zhang, Jun</creator><creator>He, Xiao‐Yan</creator><creator>Liu, Nan‐Jing</creator><creator>Liu, Jiang‐Bin</creator><creator>Zou, Lin</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2772-0393</orcidid><orcidid>https://orcid.org/0000-0003-0851-1203</orcidid></search><sort><creationdate>202207</creationdate><title>Prognostic impact of tumor size on patients with neuroblastoma in a SEER‐based study</title><author>Wang, Jin‐Xia ; Cao, Zi‐Yang ; Wang, Chun‐Xia ; Zhang, Hong‐Yang ; Fan, Fei‐Long ; Zhang, Jun ; He, Xiao‐Yan ; Liu, Nan‐Jing ; Liu, Jiang‐Bin ; Zou, Lin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5763-79bca0ef1ffdf17008a57c6cf470a1288313023880ef1e601d49208f6aec0e733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Cancer</topic><topic>Confidence intervals</topic><topic>Epidemiology</topic><topic>Histology</topic><topic>Medical prognosis</topic><topic>Neuroblastoma</topic><topic>Population</topic><topic>Prognosis</topic><topic>Regression analysis</topic><topic>Risk factors</topic><topic>SEER</topic><topic>Size distribution</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Survival</topic><topic>survival analysis</topic><topic>tumor size</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, Jin‐Xia</creatorcontrib><creatorcontrib>Cao, Zi‐Yang</creatorcontrib><creatorcontrib>Wang, Chun‐Xia</creatorcontrib><creatorcontrib>Zhang, Hong‐Yang</creatorcontrib><creatorcontrib>Fan, Fei‐Long</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><creatorcontrib>He, Xiao‐Yan</creatorcontrib><creatorcontrib>Liu, Nan‐Jing</creatorcontrib><creatorcontrib>Liu, Jiang‐Bin</creatorcontrib><creatorcontrib>Zou, Lin</creatorcontrib><collection>Open Access: Wiley-Blackwell Open Access Journals</collection><collection>Wiley Online Library Free Content</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>PHMC-Proquest健康医学期刊库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Biological Science Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Cancer medicine (Malden, MA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, Jin‐Xia</au><au>Cao, Zi‐Yang</au><au>Wang, Chun‐Xia</au><au>Zhang, Hong‐Yang</au><au>Fan, Fei‐Long</au><au>Zhang, Jun</au><au>He, Xiao‐Yan</au><au>Liu, Nan‐Jing</au><au>Liu, Jiang‐Bin</au><au>Zou, Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic impact of tumor size on patients with neuroblastoma in a SEER‐based study</atitle><jtitle>Cancer medicine (Malden, MA)</jtitle><addtitle>Cancer Med</addtitle><date>2022-07</date><risdate>2022</risdate><volume>11</volume><issue>14</issue><spage>2779</spage><epage>2789</epage><pages>2779-2789</pages><issn>2045-7634</issn><eissn>2045-7634</eissn><abstract>Objective
The prognostic value of tumor size in neuroblastoma (NB) patients has not been fully evaluated. Our purpose is to elucidate the prognostic significance of tumor size in surgery performed on neuroblastoma patients.
Methods
Neuroblastoma patients diagnosed from 2004 to 2015 were selected from the Surveillance, Epidemiology, and End Results Program (SEER) for the study. Univariate and multivariate Cox proportional hazard regression models were used to identify risk factors and the independent prognostic influences of tumor size on NB patients. Overall survival (OS) was analyzed through univariate Cox regression analysis. To determine the optimal cutoff value of tumor size, we first divided the cohort into three groups (≤5 cm, 5–10 cm, >10 cm). Subsequently, the patients were divided into two groups repeatedly, with tumor size at 1 cm intervals. The cutoff value that maximized prognostic outcome difference was selected. Furthermore, we performed the Kaplan–Meier methods to visually present differences in prognosis between the optimal tumor size cutoff value in different subgroups.
Results
A total of 591 NB patients who met the inclusion criteria were selected from the SEER database in this study. Cox analysis showed that age >1 year (HR = 2.42, p < 0.0001), originate from adrenal site (HR = 1.7, p = 0.014), distant stage (HR = 6.4, p < 0.0001), undifferentiated grade (HR = 1.94, p = 0.002), and large tumor size (HR = 1.5, p < 0.0001) independently predicted poor prognosis. For tumor size, there were significant differences in tumor size distribution in different ages, tumor grade, disease stage, and primary site subgroup but not in sex, race, and histology subgroup. Furthermore, both univariate (HR = 4.96, 95% CI 2.31–10.63, p < 0.0001) and multivariable analysis (HR = 2.8, 95% CI 1.29–6.08, p < 0.0001) indicated the optimal cutoff value of tumor size was 4 cm for overall survival of NB patients. Using a 4 cm of tumor size cutoff in subgroups, we found that it can identify poor prognosis patients whatever their age or primary site. Interestingly, tumor size of 4 cm cutoff can only identify unfavorable NB patients with diagnosis at distant‐stage disease, or differentiated grade tumor, but not with regional and local or undifferentiated tumor.
Conclusions
Tumor size is first to be recognized as a key prognostic factor of neuroblastoma patients and a cutoff value >4 cm might predict poor prognosis, which should be included in the evaluation of prognostic factors for NB.
we found that tumor size could independently predict prognosis in NB patients, and a single cut‐off at 4 cm that maximized prognostic discrimination of NB children was essential for identify the poor prognosis subgroup.</abstract><cop>United States</cop><pub>John Wiley & Sons, Inc</pub><pmid>35315591</pmid><doi>10.1002/cam4.4653</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-2772-0393</orcidid><orcidid>https://orcid.org/0000-0003-0851-1203</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Open Access: Wiley-Blackwell Open Access Journals; Publicly Available Content Database; PubMed Central |
| subjects | Age Cancer Confidence intervals Epidemiology Histology Medical prognosis Neuroblastoma Population Prognosis Regression analysis Risk factors SEER Size distribution Statistical analysis Surgery Survival survival analysis tumor size Tumors |
| title | Prognostic impact of tumor size on patients with neuroblastoma in a SEER‐based study |
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