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Clinical and socioeconomic determinants of survival in biliary tract adenocarcinomas

World Journal of Gastrointestinal Oncology 2024年第4期16卷 1374-1383页

作者： Laura Sahyoun Kay Chen Cynthia Tsay George Chen petr protiva Department of Gastroenterology and Hepatology Weill Cornell MedicineNew YorkNY 10065United States Gastroenterology Section Jennifer Moreno VA San Diego Healthcare SystemSan DiegoCA 92161United States Division of Gastroenterology Department of MedicineUniversity of California San DiegoLa JollaCA 92093United States Department of Gastroenterology and Hepatology John Hopkins HospitalBaltimoreMD 21287United States Department of Digestive Diseases Yale New Haven HospitalNew HavenCT 06520United States Department of Gastroenterology VA Connecticut Health Care SystemWest HavenCT 06516United States

BACKGROUND Despite advances in detection and treatments,biliary tract cancers continue to have poor survival ***,there is limited data investigating the significance of socioeconomic status,race/ethnicity,and environmental factors in biliary tract cancer *** from the Surveillance,Epidemiology,and End Results database for biliary and gallbladder adenocarcinomas were extracted from 1975 to ***-conomic data included smoking,poverty level,education,adjusted household income,and percentage of foreign-born persons and urban *** was calculated with Cox proportional hazards models for death in the 5-year period following *** Our study included 15883 gallbladder,11466 intrahepatic biliary,12869 extrahepatic biliary and 7268 ampulla of Vater adenocarcinoma *** analyzing county-specific demographics,patients from counties with higher incomes were associated with higher survival rates[hazard ratio(HR)=0.97,P<0.05].Similarly,counties with a higher percentage of patients with a college level education and counties with a higher urban population had higher 5-year survival rates(HR=0.96,P=0.002 and HR=0.97,P=0.004,respectively).CONCLUSION Worse survival outcomes were observed in lower income counties while higher income and education level were associated with higher 5-year overall survival among gallbladder and biliary malignancies.

关键词： Biliary tract cancers Survival Outcomes research Socioeconomic factors Healthcare disparities

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Sessile serrated adenomas in the proximal colon are likely to be flat,large and occur in smokers

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World Journal of Gastroenterology 2013年第32期19卷 5271-5277页

作者： Tarun Rustagi Priya Rangasamy Matthew Myers Melinda Sanders Haleh Vaziri George Y Wu John W Birk petr protiva Joseph C Anderson Section of Digestive Diseases Department of Internal MedicineYale University School of MedicineNew HavenCT 06520United States Department of Gastroenterology University of Connecticut Health CenterFarmingtonCT 06032United States Department of Pathology University of Connecticut Health CenterFarmingtonCT 06063United States Department of Gastroenterology VA West HavenYale School of MedicineNew HavenCT 06520United States Department of Gastroenterology VA Medical CenterWindsorVT 05009United States The Geisel School of Medicine at Dartmouth Medical HanoverNH 03755United States

AIM:To examine the epidemiology and the morphology of the proximal sessile serrated adenomas(SSAs).METHODS:We conducted a retrospective study to identify patients with SSAs using a university-based hospital pathology database query from January 2007to April *** collected included:age,gender,ethnicity,body mass index,diabetes,smoking,family history of colorectal cancer,aspirin,and statin *** collected data on morphology of SSAs including site(proximal or distal),size,and endoscopic appearance(flat or protuberant).We also compared proximal SSAs to proximal tubular adenomas detected during same time ***:One hundred and twenty patients with SSAs were identified:61%were distal and 39%were proximal *** SSAs were more likely to be flat than distal(100%vs 78%respectively;P=0.0001).Proximal SSAs were more likely to occur in smokers(OR=2.63;95%CI:1.17-5.90;P=0.02)and in patients with family history of colorectal cancer(OR=4.72;95%CI:1.43-15.55;P=0.01)compared to *** SSAs were statistically more likely to be≥6 mm in size(OR=2.94;P=0.008),and also more likely to be large(≥1 cm)(OR=4.55;P=0.0005)compared to the distal *** were more likely to have proximal(P=0.02),flat(P=0.01)and large(P=0.007)SSAs compared to *** to proximal tubular adenomas,proximal SSAs were more likely to be large and occur in ***:Proximal SSAs which accounted for two-fifths of all SSAs were more likely to present as flat lesions,larger SSAs,and were more likely to occur in smokers and in patients with family history of colorectal *** data has implications for colorectal cancer screening.

关键词： Proximal Sessile Serrated Adenoma Colonoscopy Colorectal cancer Smoking

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