Abstract 2357
Background
Cancer is mainly diagnosed by histopathology, but some complex situations may provoke physicians’ desire to avoid biopsy. This is particularly important when cancer diagnosis can be made based on other less accurate methods like radiological findings or elevated tumor markers e.g. suspicious ovarian mass with elevated CA125. However, data about these cases treated based on diagnosis “prediction” rather than accurate definition of histopathology are lacking. In this study, survival is compared between cases with microscopic confirmation of diagnosis and those diagnosed with other methods. This is presented for all types of cancer but with particular focus on four main tumors where other modalities for diagnosis may be appealing.
Methods
Data were obtained using SEER*Stat version 8.3.5 (SEER 18 Regs Nov 2017 Submission). Only cases diagnosed between 2001 and 2010 were included. Observed survival was calculated using SEER*Stat where other data analysis including Kaplan Meier analysis was made using SPSS.
Results
Microscopic confirmation (MC) was the mainstay for diagnosis in most of included cases (n = 3594344; 94.2%). In the remaining group (non-microscopically confirmed (NMC) diagnosis, n = 222907; 5.8%), radiography was used in 46% (n = 102401). Clinical diagnosis, positive laboratory test/marker, and direct visualization were used in 11.8%, 5.2%, and 2.7 respectively. There was a significant survival difference between MC and NMC that was consistent in prostate, ovarian, liver, and pancreatic cancer as well as in other types of malignancies (p < 0.05). The table shows the 5-years observed survival and 95% CI for different types of cancer in the two groups.Table: 1600P
| 5-years observed survival | ||
|---|---|---|
| MC | NMC | |
| Prostate | 85.3% (85.2-85.4) | 26.6% (25.8-27.5) |
| Ovary | 44.1% (43.6-44.6) | 10.9% (9.8-12) |
| Liver | 18.1% (17.7-18.5) | 9.6% (9.2-10.1) |
| Pancreas | 6.5% (6.3-6.7) | 2.6% (2.3-2.9) |
| Others | 67.4% (57.3-57.4) | 14.7% (14.4-14.9) |
| All | 60.5% (60.6-60.6) | 13.7% (13.5-13.8) |
Conclusions
Microscopic confirmation should be regarded as the only accurate method for diagnosis of cancer. Depending on other diagnosis methods may have a strong detrimental effect on survival. More studies needs to address possible explanations for these findings and potential implications on management.
Clinical trial identification
Legal entity responsible for the study
Mohamed Alaa Gouda.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
The author has declared no conflicts of interest.
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