Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database

Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database

Zain Hussain, Jawad Khan, Shaheer Ali Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USACorrespondence: Zain HussainPaul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr., El Paso, TX, 79905, USAEmail zain.huss...

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Autores principales: Hussain Z, Khan J, Ali S
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
choroid
cancer
survival
mortality
Ophthalmology
RE1-994
Acceso en línea:https://doaj.org/article/6493419353d6446fb7bd1b086fe2862c
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spelling oai:doaj.org-article:6493419353d6446fb7bd1b086fe2862c2021-12-02T17:35:10ZImpact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database1177-5483https://doaj.org/article/6493419353d6446fb7bd1b086fe2862c2021-04-01T00:00:00Zhttps://www.dovepress.com/impact-of-therapy-amp-age-in-choroidal-cancers-a-retrospective-cohort--peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Zain Hussain, Jawad Khan, Shaheer Ali Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USACorrespondence: Zain HussainPaul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr., El Paso, TX, 79905, USAEmail zain.hussain@ttuhsc.eduBackground: Collectively, choroidal cancers represent a vast array of histopathologically diverse constituencies with profound repercussions related to mortality and metastasis. Prognosticated factors provide utility in determining clinical management and outcome propensities. To date, measures to collectively characterize choroidal cancers as a class are not impressive. This study aims to shed light on the affiliation of age and therapeutic modalities to survival in patients diagnosed with choroidal cancers.Methods: Cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) program, a freely accessible population-based database, was executed from 1975 to 2016, a 41-year time window. Univariable and multivariable Cox regression assessed survival with age and various therapeutic modalities as primary independent variables. Adjustment for several demographical and clinical variables was performed.Results: This cohort consisted of 7722 patients at the time of diagnosis. Multivariable Cox regression demonstrated increased cause-specific hazards of 71.8% for patients aged 75+ years (HR = 1.718, CI 1.155– 2.555, p < 0.008) as compared to patients aged 0– 24 years. 16.2% and 58.0% increases in cause-specific mortality were showcased in patients diagnosed with 8770/3: mixed epithelioid and spindle cell melanoma (HR = 1.16, p = 0.029) and 8771/3: epithelioid cell melanoma of the choroid (HR = 1.580, p < 0.001) compared to individuals diagnosed with 8720/3: malignant melanoma NOS of the choroid. Chemotherapy significantly influenced survival in patients with choroidal cancers compared to those who did not receive chemotherapy or had an unknown status (HR = 0.377, CI 0.292– 0.486, p < 0.001).Conclusion: Like most cancers, choroidal cancers showcase poor clinical trajectory with advanced age. Specific ICD-O-3 histological subtypes predispose to increased mortality. Therapeutic modalities such as radioactive implants and chemotherapeutic agents demonstrate decreased cause-specific mortality compared to alternative treatments. Altogether, nuanced influences of age and therapy are revealed when evaluating choroidal cancers as a class, irrespective of subtype.Keywords: choroid, cancer, survival, mortalityHussain ZKhan JAli SDove Medical PressarticlechoroidcancersurvivalmortalityOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1763-1774 (2021)
institution DOAJ
collection DOAJ
language EN
topic choroid
cancer
survival
mortality
Ophthalmology
RE1-994
spellingShingle choroid
cancer
survival
mortality
Ophthalmology
RE1-994
Hussain Z
Khan J
Ali S
Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
description Zain Hussain, Jawad Khan, Shaheer Ali Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USACorrespondence: Zain HussainPaul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr., El Paso, TX, 79905, USAEmail zain.hussain@ttuhsc.eduBackground: Collectively, choroidal cancers represent a vast array of histopathologically diverse constituencies with profound repercussions related to mortality and metastasis. Prognosticated factors provide utility in determining clinical management and outcome propensities. To date, measures to collectively characterize choroidal cancers as a class are not impressive. This study aims to shed light on the affiliation of age and therapeutic modalities to survival in patients diagnosed with choroidal cancers.Methods: Cohort analysis using the Surveillance, Epidemiology, and End Results (SEER) program, a freely accessible population-based database, was executed from 1975 to 2016, a 41-year time window. Univariable and multivariable Cox regression assessed survival with age and various therapeutic modalities as primary independent variables. Adjustment for several demographical and clinical variables was performed.Results: This cohort consisted of 7722 patients at the time of diagnosis. Multivariable Cox regression demonstrated increased cause-specific hazards of 71.8% for patients aged 75+ years (HR = 1.718, CI 1.155– 2.555, p < 0.008) as compared to patients aged 0– 24 years. 16.2% and 58.0% increases in cause-specific mortality were showcased in patients diagnosed with 8770/3: mixed epithelioid and spindle cell melanoma (HR = 1.16, p = 0.029) and 8771/3: epithelioid cell melanoma of the choroid (HR = 1.580, p < 0.001) compared to individuals diagnosed with 8720/3: malignant melanoma NOS of the choroid. Chemotherapy significantly influenced survival in patients with choroidal cancers compared to those who did not receive chemotherapy or had an unknown status (HR = 0.377, CI 0.292– 0.486, p < 0.001).Conclusion: Like most cancers, choroidal cancers showcase poor clinical trajectory with advanced age. Specific ICD-O-3 histological subtypes predispose to increased mortality. Therapeutic modalities such as radioactive implants and chemotherapeutic agents demonstrate decreased cause-specific mortality compared to alternative treatments. Altogether, nuanced influences of age and therapy are revealed when evaluating choroidal cancers as a class, irrespective of subtype.Keywords: choroid, cancer, survival, mortality
format article
author Hussain Z
Khan J
Ali S
author_facet Hussain Z
Khan J
Ali S
author_sort Hussain Z
title Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
title_short Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
title_full Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
title_fullStr Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
title_full_unstemmed Impact of Therapy & Age in Choroidal Cancers: A Retrospective Cohort Analysis of 7722 Patients from a US National Database
title_sort impact of therapy & age in choroidal cancers: a retrospective cohort analysis of 7722 patients from a us national database
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/6493419353d6446fb7bd1b086fe2862c
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AT alis impactoftherapyampageinchoroidalcancersaretrospectivecohortanalysisof7722patientsfromausnationaldatabase
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