Browsing by Subject "Grade"

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    Acinic Cell Carcinoma in the 21st Century: A Population-Based Study from the SEER Database and Review of Recent Molecular Genetic Advances
    (MDPI, 2023-06-27) Khan, Jaffar; Ullah, Asad; Goodbee, Mya; Lee, Kue Tylor; Yasinzai, Abdul Qahar Khan; Lewis, James S., Jr.; Mesa, Hector; Pathology and Laboratory Medicine, School of Medicine
    Background: Acinic cell carcinoma (AciCC) comprises 6-7% of all salivary gland neoplasms and is the second most common salivary gland malignancy in children. Like many salivary gland carcinomas, it is considered low grade but occasionally it behaves aggressively. Understanding the risk factors associated with recurrence, metastasis, and death is important to determine the counseling and management of individual patients. Older population-based studies are presumed to have been confounded by the misclassification of other neoplasms as AciCC, in particular secretory carcinoma and cystadenocarcinoma. Since diagnostic tools to reliably separate these entities have been available for over a decade, reevaluation of epidemiologic data limited to the 21st century should allow a better characterization of the clinicopathological characteristics of AciCC. Methods: Our study extracted data from the Surveillance, Epidemiology, and End Results (SEER) database for the period 2000 to 2018. Cox regression model analysis was performed to identify risk factors independently affecting survival. Results: Data for 2226 patients with AciCC were extracted from the database. Most patients were females: 59%, and white: 80.5%, with a mean age at diagnosis of 51.2 (SD ± 18.7) years. Most cases (81%) were localized at presentation. Tumor size was less than 2 cm in 42%, 2-4 cm in 47%, and >4 cm in 11%. Low-grade tumors had 5-year survival > 90%, whereas high-grade tumors had survival < 50%. Of the patients with known lymph node status only 7.3% had nodal metastases. Distant metastases were documented in 1.1%, involving lungs 44%, bone 40%, liver 12%, and brain 4%. The most common treatment modality was surgery alone: 63.6% followed by surgery and adjuvant radiation: 33%. A few received chemotherapy (1.8%) or multimodality therapy (1.2%). The 5-year overall survival rate was 90.6% (95%CI 89.1-91.9), and disease-specific survival was 94.6% (95%CI 93.3-95.6). Multivariable cox regression analysis showed that undifferentiated (HR = 8.3) and poorly differentiated tumor grade (HR = 6.4), and metastasis (HR = 5.3) were the worst independent prognostic factors. Other poor risk factors included age > 50 (HR = 3.5) and tumor size > 4 cm (HR = 2.5). Conclusions: In the US, AciCC is more common in middle age white females, and most tumors are less than 4 cm and localized at diagnosis. The most relevant negative prognostic factor was high tumor grade which was associated with higher hazard ratios for death than all other variables, including regional or distant metastases at presentation.
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    Consensus and controversy in the management of paediatric and adult patients with ovarian immature teratoma: the Malignant Germ Cell International Consortium perspective
    (Elsevier, 2024-02-06) Pashankar, Farzana; Murray, Matthew J.; Gell, Joanna; MacDonald, Nicola; Shamash, Jonathan; Billmire, Deborah F.; Klosterkemper, Lindsay; Olson, Thomas; Hirsch, Michelle S.; Lockley, Michelle; Stoneham, Sara; Frazier, A. Lindsay; Surgery, School of Medicine
    Ovarian immature teratoma (IT) is a rare neoplasm comprising ∼3% of ovarian cancers, occurring primarily in young females. Management presents several challenges, including those with elevated serum alpha-fetoprotein, potential confusion regarding pathology interpretation, and paucity of data to support decision-making. MaGIC (https://magicconsortium.com/) is an interdisciplinary international consortium of GCT experts from multiple subspecialties, with members receiving frequent queries regarding IT patient management. With evidence from published literature where available, we summarise consensus management of such patients. Given lack of published data, controversy in certain areas remains. The most obvious variance in practice is between paediatric and adult teams, despite very similar outcomes. Paediatric teams typically employ a surgery-only approach, whereas in adult practice, all patients, except those with stage IA, grade 1 (low-grade) tumours, still generally receive adjuvant chemotherapy. Given the rarity of ovarian IT and lack of published data, discussion with GCT experts and/or national advisory panels is recommended.
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    Understanding online K-12 students through a demographic study
    (Contact Nord, 2014-12) Corry, Michael; Dardick, William; Ianacone, Robert; Stella, Julie; Technology and Leadership Communication, School of Engineering and Technology
    Online K-12 learning opportunities have proliferated, but much remains to be understood about the characteristics of participating students. This study presents a demographic profile of fulltime, K-12 online learners today and compares them with public school students nationwide in the United States. The data was collected from a parent survey that produced 119,155 valid responses/records for students enrolled full-time in online K-12 public schools in 43 states. The study shows that the online student population includes somewhat more females than males, and more middle school than elementary or high school students. White students are overrepresented among full-time online learners compared with their share of the nationwide student population, while Hispanic/Latino and Asian/Pacific Islander students are underrepresented. Gifted and talented students and English language learners (ELLs) are also underrepresented. These data provide a baseline for more detailed explorations and can assist practitioners, policy makers, and researchers in making important decisions about online education that have implications for all students.