Japanese journal of clinical oncology最新文献

Lung cancer is the leading cause of cancer death worldwide. To aid the development of lung cancer control strategies, we analyzed trends in lung cancer survival using data from 16 population-based cancer registries in Japan that participated in the CONCORD-3 study. We included patients aged 15-99 years diagnosed with lung cancer between 2000 and 2014 and followed up until 31 December 2014. A total of 5-year net survival was estimated using the Pohar Perme estimator, stratified by calendar period, age group, sex, histological subtype, and stage. All-ages estimates were standardized with the International Cancer Survival Standard weights. Age-standardized 5-year net survival in 339 277 patients with lung cancer increased slightly over time, from 29.3% (95% confidence intervals 28.1%-30.5%) for patients diagnosed during 2000-2004 to 32.9% (32.3%-33.4%) in 2010-2014. Five-year net survival improved particularly for young patients (15-44 years), for women diagnosed with non-small cell lung cancer and with localized disease. We observed limited or no survival improvement for patients diagnosed with small-cell lung cancer or with distant disease. In Japan, 5-year net survival for patients with lung cancer improved slightly over the 15 years 2000-2014, but no improvement was observed for patients with small-cell lung cancer or with distant disease. Continued surveillance of cancer survival is essential to guide cancer control efforts and further improve treatment outcomes.

Background: Breast, cervical and ovarian cancers significantly affect young and middle-aged women, both physically and socially. However, relevant comprehensive stratified analyses are limited. Using Japanese data from CONCORD-3, a global cancer survival surveillance program, we analyzed long-term survival trends.

Methods: Data from 16 Japanese population-based cancer registries were analyzed for women diagnosed aged 15-99 years during 2000-2014 with a tumor originating in the breast, cervix uteri or ovaries. Follow-up was extended to five years post-diagnosis or until December 31st, 2014. In situ tumors and death-certificate-only registrations were excluded. Five-year net survival was estimated with the Pohar Perme estimator by calendar period of diagnosis, morphology and stage, and age-standardized with International Cancer Survival Standard weights.

Results: During 2000-2014, 5-year net survival improved for breast cancer from 85.9% (95% CI, 85.2-86.6%) to 89.4% (88.9-89.9%), for cervical cancer from 67.5% (66.3-68.7%) to 71.4% (70.4-72.3%), and for ovarian cancer from 35.5% (33.8-37.2%) to 46.3% (44.9-47.7%). Five-year survival for tumors diagnosed at a localized stage remained consistently high (>98% for breast cancer and > 90% for cervical cancer). Ovarian cancer survival varied greatly according to morphology.

Conclusions: Five-year net survival for women with cancers of the breast, cervix, and ovary) in Japan improved during 2000-2014, and remained at a globally high level throughout this period. These gains are probably attributable to earlier detection of breast and cervical cancers and advances in multimodal treatment for all cancers. Survival for distant-stage cervical and ovarian cancers remains a challenge, underscoring the need for enhanced screening and treatment strategies.

Background: We estimated net survival trends for patients with stomach cancer registered in 16 regional population-based cancer registries in Japan that participated in the CONCORD-3 study.

Methods: We included data on adults (15-99 years) diagnosed with stomach cancer between 2000 and 2014 and followed-up for their vital status until 31 December 2014. We grouped cancer patients into three anatomic groups (proximal, distal, and overlapping regions and stomach cancer, not otherwise specified) with the International Classification of Disease for Oncology, Third edition topography codes. We estimated 5-year net survival with the Pohar Perme estimator for three calendar periods (2000-2004, 2005-2009, 2010-2014), by age group (15-44, 45-54, 55-64, 65-74, and 75-99 years), anatomic group, and stage at diagnosis. All-ages survival estimates were age-standardized using the International Cancer Survival Standard weights.

Results: Five-year net survival improved over time, from 50.5% in 2000-2004 to 57.6% and 60.3% in 2005-2009 and 2010-2014, respectively. Survival for patients with proximal stomach cancer improved from 49.7% in 2000-2004 to 53.5% 2005-2009 and plateaued to 53.1% in 2010-2014. Survival for distal stomach cancer increased from 64.8% in 2000-2004 to 67.6% and 68.2% in 2005-2009 and 2010-2014, respectively. In 2010-2014, 5-year net survival for patients with localized disease (94.8%) was much higher than survival for regional (53.7%) and distant (6.4%) disease.

Conclusions: Five-year net survival for stomach cancer improved noticeably during 2000-2014. This improvement might be due to advances in systemic chemotherapy. Although survival in distal stomach cancer had improved, no such improvement was seen in proximal stomach cancer. Standardizing esophagogastric junction cancer treatment may improve its outcomes and contribute to better survival in proximal stomach cancer overall. Scientific evaluation of screening programs is also needed to enhance the efficacy of stomach cancer control initiatives in Japan.

Background: In 2018, CONCORD-3 updated long-term surveillance of cancer survival trends worldwide. In this monograph, we conducted further analyses and examined trends in net survival using the Japanese data during 2000-14.

Methods: Sixteen population-based cancer registries in Japan contributed data to CONCORD-3 with anonymized individual records on 2 237 861 patients diagnosed with one of 15 adult cancers (15-99 years), and brain tumors and hematological malignancies in children (0-14 years). Five-year net survival was estimated with the Pohar Perme estimator and age-standardized with International Cancer Survival Standard weights. We estimated survival for three calendar periods, by age group, sex, anatomic site or morphology, and by stage at diagnosis.

Results: Five-year net survival improved between 2000-04 and 2010-14 for several cancers, including brain tumors (27.9%-46.3%), ovarian cancer (35.5%-46.3%), stomach cancer (50.5%-60.3%), lymphoid malignancies (47.5%-57.3%), myeloid malignancies (24.8%-33.3%), and esophageal cancer (27.7%-36.0%). Breast cancer, childhood lymphoma, and prostate cancer showed consistently high or improving survival (85.9%-93.0%). In contrast, survival for melanoma remained unchanged. Net survival was low for pancreatic cancer (6.9%-8.3%). Among selected countries, survival was higher in Japan for esophageal (36.0%), liver (30.1%), and lung cancers (32.9%). Survival for melanoma, hematologic malignancies, and childhood cancers was lower in Japan than in Western countries.

Conclusions: Net survival in Japan improved substantially for several cancers, but survival for pancreatic cancer remained low. International collaboration is crucial to accelerate the development of effective cancer control strategies.

Background: We aimed at assessing 15-year trends in 5-year net survival for men diagnosed with prostate cancer during 2000-2014 and registered by 16 Japanese regional population-based cancer registries included in the CONCORD-3 study.

Methods: We included data on adult men (15-99 years) diagnosed with prostate cancer during 2000-2014 and followed-up to 31 December 2014. We grouped patients into five age groups (15-54, 55-64, 65-74, 75-84, and 85-99 years) and four morphology groups according to the ICD-O-3 classification (epithelial, neuroendocrine, other specified morphologies, and malignant neoplasm, not otherwise specified). We grouped patients by stage at diagnosis into localized, regional, and advanced disease. We estimated 5-year net survival by age group, morphological subtype and stage using the Pohar Perme estimator, correcting for background mortality. All-ages estimates were standardized with the International Cancer Survival Standard weights.

Results: Age-standardized 5-year net survival increased over time, from 85.9% in 2000-2004 to 93.0% in 2010-2014. Survival was higher than 90% for epithelial tumors, and for localized and regional disease. Five-year net survival for patients with distant metastasis was poor at 47.3% (95% CI. 39.4-55.1%) during 2010-2014.

Conclusions: The improvement in survival for prostate cancer may be due to the high and increasing proportion of patients with localized disease and with epithelial tumors, for which 5-year survival approaches 100%. A comprehensive analysis of long-term survival over a longer period of time would be essential to investigate further the factors contributing to the increasing trend in survival.

Background: Brain tumors are a serious health issue, and survival is an effective indicator of how the healthcare system manages them. We examined net survival trends for patients diagnosed with a primary brain tumor during 2000-2014 in Japan, using data from 16 regional population-based cancer registries participating in the CONCORD-3 study.

Methods: We included patients aged 15-99 years, with follow-up completed either 5 years after diagnosis or up to 31 December, 2014. We estimated 5-year net survival by age group and morphological subtype using the Pohar Perme estimator, and age-standardized with International Cancer Survival Standard weights.

Results: Five-year net survival for brain tumors increased from 27.9% for patients diagnosed during 2000-2004 to 46.3% in 2010-2014. During 2010-2014, 5-year net survival for astrocytic tumors was 22.3%, but ~90% for neuronal and mixed neuro-glial tumors, germ cell tumors, and other specified tumors. Five-year net survival reached 62.1% for oligodendroglial and oligoastrocytic tumors.

Conclusions: Five-year net survival for brain tumors in Japan improved during 2000-2014, with remarkable variations by morphologic type. Survival improved for all age groups, and particularly for younger patients, highlighting the need for enhanced survivorship care. Japan's focus on comprehensive data collection and supportive care for longer-term survivors remains key for further progress. When comparedinternationally, Japan's gains sit at the higher end of reported survival ranges, underscoring how robust registry infrastructure and equitable access to care could inform strategies for brain tumor care.

A BRCA2 germline variant, NM_000059.4: c.8487G > A (p.Gln2829Gln), was identified in a Japanese female with multifocal breast cancer and a notable family history of BRCA2-related cancers. While this synonymous variant was reported as a variant of uncertain significance, we suspected its pathogenicity considering its location at the 3' end of exon 19. This variant is absent in gnomAD and extremely rare in ToMMo jMorp 61KJPN database, with an allelic frequency of 0.000008. All three in silico tools predicted a splicing defect. RT-PCR analysis using total RNA extracted from the patient's peripheral blood cells demonstrated skipping of entire exon 19, resulting in in-frame deletion. This observation was consistent with a previous report of in vitro minigene assay. The exon 19 encodes 52 amino acids within the single-stranded DNA oligonucleotide/oligosaccharide-binding domain, and thus the in-frame deletion was predicted to impair BRCA2 function. Collectively, we re-classified this variant as likely pathogenic.

Background: Histological variants (HV) are associated with aggressiveness in urothelial carcinoma (UC). Although immune checkpoint inhibitor (ICI) therapy has improved the prognosis of patients with metastatic UC with HV (HV-UC), the factors determining the prognosis of these patients following ICI therapy remain unclear.

Methods: The present, retrospective, multicentric study (YUSHIMA study-04) included patients with histologically confirmed metastatic UC who received pembrolizumab as a second-line or later therapy between January 2018 and June 2023. The primary endpoint was the assessment of differences in prognostic factors of progression-free survival (PFS) and overall survival (OS) in patients with HV-UC and those with pure UC (pUC).

Results: The study cohort consisted of 61 and 331 patients with HV-UC and pUC, respectively, having comparable PFS and OS. The presence of lymph node metastasis (LNM) was independently associated with longer PFS (multivariable hazard ratio [mHR]: 0.35; P = .02) and OS (mHR: 0.25; P = .002) in the HV-UC group but was not in the pUC group (univariate HR: 1.10; P = .54 and HR: 1.05; P = .76, respectively). When the prognosis of the groups was compared by LNM status, a subpopulation of patients without LNM in the HV-UC group had significantly shorter PFS (P = .003) and OS (P = .008).

Conclusions: The presence of LNM may be a HV-UC-specific prognostic factor of a favorable outcome in patients with mUC receiving pembrolizumab as second-line or later therapy.

Introduction: Multiple myeloma (MM) remains incurable although a subset of patients achieves survival ≥10 years. However, whether nutritional background predicted long-term survival (LTS), which defined as overall survival (OS) over 10 years, or not remains unclear. This retrospective study aimed to identify the clinical and nutritional factors associated with LTS in patients with MM.

Methods: We retrospectively analyzed data from 163 patients with newly diagnosed MM aged <80 years between 2009 and 2014. Geriatric nutritional risk index (GNRI) was a nutritious biomarker and calculated by height, weight, and serum albumin.

Results: The perception of LTS was 20.9%. The cutoff of GNRI was defined as 91.715 using receiver operating characteristic curve to predict LTS. High GNRI was associated with low incidence of CRAB symptoms and international staging system III in patient characteristics. In the 4.6-year median follow-up period, 10-year OS rate in high GRNI group was higher than those in the low GNRI group (39.6% vs 27.9%; hazard ratio [HR], 0.667; P = .050). In the multivariate analysis, high GNRI and early progressive disease (PD) were identified as significant prognostic factors for OS (HR, 0.538; P = .049, and HR, 1.848; P = .040, respectively). We explored a new prognostic model using GNRI and early PD status; the 10-year OS rate in patients with high GNRI without early PD were 49.2%. High GNRI was independent predictors of LTS, and predicted long OS combining with early PD.

Conclusions: The prognostic significance of host nutritional status played an important role for long survival.