Defining survivorship and surveillance with evidence.

• DOI: 10.1200/jco.2018.36.15_suppl.6528
• Publication Date: 2018-09-05T10:38:26Z
• Authors: Robert Dood; Yang Zhou; Shannon Dawn Armb...; Shelley Tworoger; Robert L. Coleman; Anil Sood; Keith A. Baggerly
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

6528 Background: Survivorship involves a multidisciplinary approach to surveillance and management of comorbidities secondary cancers, however timing is based on arbitrary 5 year cutoffs. Here, we used novel method analyzing annualized mortality rates systematically define these cut-offs for transitions care. Methods: The SEER database was queried survival data patients aged 18-100 years with any incident diagnosis cancer, grouped by ICD-O-3 tumor type. Excess hazard, calculated as an risk above the baseline population plotted over time. time this hazard took stabilize defined high-risk period. % morality elevation age/sex-matched controls in latter low-risk stable period reported gap. Results: Over 2.3 million 68 different primary types were evaluated. High periods ranged from 1 month 21 years. durations under (breast, prostate, lip, ocular, parathyroid cancers) up 19 (unspecified gastrointestinal cancers). Cluster analysis produced 6 groups. Subanalyses selected revealed that stratifying stage histologic type can change cluster guidance Conclusions: These findings indicate standardized both inadequate some cancers while excessive others. require most resources longest period, highest persistent risk, cancer mortality, all arguing longer follow-up oncologist. Medians (5-95 %ile). High-risk yrs Mortality gap, Cancer 2.5 (0.0-5.0) 1.4% (0.3-2.4) Prostate, Breast, Cervix, Skin, Uterine corpus, Thyroid 2 7.5 (5.0-12.6) 2.9% (1.4-4.8) Hematologic, Ovary, Gum/mouth, Tongue, Oropharynx 3 5.0 (4.0-8.0) 2.4% (0.9-4.5) Colon, Bladder, Lymph node, Kidney, Rectum, Larynx 4 6.5 (5.3-10.8) 3.4% (2.0-8.5) Hypopharynx, Pharynx, Ill-defined, NOS 9.0 (6.4-16.9) (1.1-6.0) Lung/bronchus, stomach, Brain/CNS, Esophagus 12.0 (9.3-12.9) 3.0% (1.1-4.2) Intrahepatic bile ducts, Pleura, Pancreas