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Age-Dependent Metastatic Spread and Survival : Cancer of Unknown Primary as a Model

Hemminki, Kari LU ; Pavlidis, Nicholas; Tsilidis, Konstantinos K; Sundquist, Kristina LU and Ji, Jianguang LU (2016) In Scientific Reports 6.
Abstract

In order to describe a novel approach for the clinical study of metastases, we provide here age-specific incidence and survival data for cancer of unknown primary (CUP). Metastases in various organs are found at CUP diagnosis, which have implications for prognosis, and we hypothesize similar prognostic implications for metastases found at diagnosis of primary cancers. We identified 33,224 CUP patients from the Swedish Cancer Registry and calculated incidence rates (IRs) for CUP development. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) for relative survival in CUP patients compared to the general population. In age-group specific analyses, a maximal IR was reached at age 85-89 years, followed... (More)

In order to describe a novel approach for the clinical study of metastases, we provide here age-specific incidence and survival data for cancer of unknown primary (CUP). Metastases in various organs are found at CUP diagnosis, which have implications for prognosis, and we hypothesize similar prognostic implications for metastases found at diagnosis of primary cancers. We identified 33,224 CUP patients from the Swedish Cancer Registry and calculated incidence rates (IRs) for CUP development. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) for relative survival in CUP patients compared to the general population. In age-group specific analyses, a maximal IR was reached at age 85-89 years, followed by a marked decline to age 90+ (7-fold in men and 3-fold in women). The overall HR for relative survival declined systematically by age. CUP may be applied as an epidemiological age-incidence model for cancer metastases providing evidence in line with autopsy data that the metastatic potential, as shown by the incidence of CUP, appears to weaken markedly at age 85 years, depending on metastatic locations. The relative death rates were highest among young patients, which was probably entirely due to the low death rates in young background population.

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author
organization
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type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
6
publisher
Nature Publishing Group
external identifiers
  • scopus:84961616006
  • wos:000372700800001
ISSN
2045-2322
DOI
10.1038/srep23725
language
English
LU publication?
yes
id
d868aec3-e02c-4ea0-97b8-ddd532b39b59
date added to LUP
2016-04-11 14:20:09
date last changed
2017-04-20 15:51:06
@article{d868aec3-e02c-4ea0-97b8-ddd532b39b59,
  abstract     = {<p>In order to describe a novel approach for the clinical study of metastases, we provide here age-specific incidence and survival data for cancer of unknown primary (CUP). Metastases in various organs are found at CUP diagnosis, which have implications for prognosis, and we hypothesize similar prognostic implications for metastases found at diagnosis of primary cancers. We identified 33,224 CUP patients from the Swedish Cancer Registry and calculated incidence rates (IRs) for CUP development. Cox proportional hazards regression models were performed to estimate hazard ratios (HRs) for relative survival in CUP patients compared to the general population. In age-group specific analyses, a maximal IR was reached at age 85-89 years, followed by a marked decline to age 90+ (7-fold in men and 3-fold in women). The overall HR for relative survival declined systematically by age. CUP may be applied as an epidemiological age-incidence model for cancer metastases providing evidence in line with autopsy data that the metastatic potential, as shown by the incidence of CUP, appears to weaken markedly at age 85 years, depending on metastatic locations. The relative death rates were highest among young patients, which was probably entirely due to the low death rates in young background population.</p>},
  articleno    = {23725},
  author       = {Hemminki, Kari and Pavlidis, Nicholas and Tsilidis, Konstantinos K and Sundquist, Kristina and Ji, Jianguang},
  issn         = {2045-2322},
  language     = {eng},
  month        = {03},
  publisher    = {Nature Publishing Group},
  series       = {Scientific Reports},
  title        = {Age-Dependent Metastatic Spread and Survival : Cancer of Unknown Primary as a Model},
  url          = {http://dx.doi.org/10.1038/srep23725},
  volume       = {6},
  year         = {2016},
}