scholarly journals Partial nephrectomy is not associated with an overall survival advantage over radical nephrectomy in elderly patients with stage Ib-II renal masses: An analysis of the national cancer data base

Cancer ◽  
2018 ◽  
Vol 124 (19) ◽  
pp. 3839-3848 ◽  
Author(s):  
Benjamin T. Ristau ◽  
Elizabeth A. Handorf ◽  
David B. Cahn ◽  
Alexander Kutikov ◽  
Robert G. Uzzo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Elderly Patients ◽  
Data Base ◽  
Partial Nephrectomy ◽  
Radical Nephrectomy ◽  
National Cancer Data Base ◽  
Survival Advantage ◽  
Renal Masses ◽  
Cancer Data ◽  
Stage Ib

Comparison of partial nephrectomy for tumors greater than 7 cm to radical nephrectomy and effect on overall survival.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 323-323 ◽  
Author(s):  
S. Vourganti ◽  
W. Linehan ◽  
G. Bratslavsky
Keyword(s):  
Overall Survival ◽  
Partial Nephrectomy ◽  
Radical Nephrectomy ◽  
Survival Advantage ◽  
Oncologic Outcomes ◽  
Rank Test ◽  
Kidney Tumors ◽  
Cancer Specific Survival ◽  
Renal Masses ◽  
Entire Cohort

323 Background: As growing evidence indicates the importance of renal functional preservation, there is an increased utilization of partial nephrectomy (PN) performed for small renal masses (SRM). The optimal cutoff size for PN has been based on historical observation of low metastatic rates for SRM and increasing metastatic potential with increase in size of the primary tumor. We aim to evaluate the outcomes of patients treated by PN or radical nephrectomy (RN) for tumors greater than 7 cm. Methods: SEER 17 database was queried to identify patients treated for kidney tumors between 1983 and 2007. We excluded cases treated for non-RCC histology, not treated surgically, and those without specified size. Patients were included if treated by PN or RN with tumor size between 7 and 20 cm. Demographic information included age, gender, and race. The comparison of RCC-specific and overall survival was performed for the entire cohort and stratified by SEER stage (localized, regional, or distant). The survival was compared using Kaplan-Meier method with log rank test to identify significant differences. Results: We identified a total of 18,927 patients treated for RCC that included 18,575 cases of RN and 352 treated with PN. There were no differences in age, gender, or race (Caucasian vs. non-Caucasian) between patients treated by RN or PN (p>0.05). The mean size for tumors treated by PN was 9.7 cm vs. 10.2 cm for RN (p<0.01) and there was more localized disease in the PN group (p<0.01). The overall median survival for patients treated with PN was 108 months vs. 80 months for patients treated with RN (p<0.01). The cancer-specific survival for the entire cohort treated with PN was 195 months vs. 145 months for RN (p<0.01). When stratified by stage, there were no differences in the cancer specific survival between PN and RN groups (p>0.05). Conclusions: PN for tumors 7 to 20 cm is not associated with inferior oncologic outcomes but may provide survival advantage. While patient selection may have influenced overall survival outcomes, PN may provide survival advantage by maximizing renal reserve. These findings may be best answered in a randomized trial to establish if there should be a size cutoff for nephron sparing surgery. No significant financial relationships to disclose.

Partial Nephrectomy for Nephroblastoma: A National Cancer Data Base Review

2018 ◽  
Vol 84 (3) ◽  
pp. 338-343 ◽  
Author(s):  
Morgan K. Richards ◽  
Adam B. Goldin ◽  
Peter F. Ehrlich ◽  
Elizabeth A. Beierle ◽  
John J. Doski ◽  
...  
Keyword(s):  
Overall Survival ◽  
Data Base ◽  
Partial Nephrectomy ◽  
Linear Models ◽  
Cox Regression ◽  
Standard Of Care ◽  
National Cancer Data Base ◽  
Margin Status ◽  
Cancer Data ◽  
Total Nephrectomy

Standard of care for unilateral nephroblastoma includes total nephrectomy (TN) with nodal sampling. We sought to compare the outcomes of TN and partial nephrectomy (PN). We performed a retrospective cohort study of TN and PN for nephroblastoma using the National Cancer Data Base. The outcomes included nodal sampling frequency, margin status, and survival. Categorical and continuous data were evaluated with χ2 and t tests, respectively ( P < 0.05). Generalized linear models evaluated nodal sampling and margin status. Cox regression compared survival. In total, 235 patients underwent PN and 3572 had TN. TN patients were 50 per cent more likely to undergo nodal sampling (RR: 1.47, 95% CI 1.30–1.66). There was no difference in margin status (RR: 0.91, 95% CI 0.65–1.28) or overall survival (HR 1.57; 95% CI 0.78–3.19). This study reports the largest review of patients with PN for unilateral nephroblastoma. PN patients had less nodal sampling but similar margin involvement and overall survival.

scholarly journals Patterns of care and predictors of adjuvant therapies in elderly patients with glioblastoma: An analysis of the National Cancer Data Base

Cancer ◽  
2017 ◽  
Vol 123 (17) ◽  
pp. 3277-3284 ◽  
Author(s):  
Mark J. Amsbaugh ◽  
Mehran B. Yusuf ◽  
Jeremy Gaskins ◽  
Eric C. Burton ◽  
Shiao Y. Woo
Keyword(s):  
Elderly Patients ◽  
Data Base ◽  
National Cancer Data Base ◽  
Patterns Of Care ◽  
Cancer Data ◽  
Adjuvant Therapies

Comparison of overall survival in gallbladder carcinoma at academic versus community cancer centers: An analysis of the National Cancer Data Base

2020 ◽  
Vol 122 (2) ◽  
pp. 176-182
Author(s):  
Chrissy Liu ◽  
Lisa Rein ◽  
Callisia Clarke ◽  
Harveshp Mogal ◽  
Susan Tsai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Data Base ◽  
Gallbladder Carcinoma ◽  
National Cancer Data Base ◽  
Cancer Centers ◽  
Cancer Data

Impact of adjuvant therapies on treatment outcomes for patients with resected gallbladder cancer and changes in treatment patterns in the United States over the past decade: An analysis from the National Cancer Data Base.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 391-391
Author(s):  
Timur Mitin ◽  
C. Kristian Enestvedt ◽  
Ahmedin Jemal ◽  
Helmneh M. Sineshaw
Keyword(s):  
Overall Survival ◽  
Gallbladder Cancer ◽  
Data Base ◽  
Adjuvant Treatment ◽  
Locally Advanced ◽  
The United States ◽  
National Cancer Data Base ◽  
Cancer Data ◽  
Adjuvant Therapies ◽  
The Past

391 Background: There are no randomized data to guide clinicians treating patients with gallbladder cancer (GBC). Several retrospective studies reported the survival benefits of adjuvant radiotherapy (RT) and chemoradiation (CRT). The aims of this study were to examine whether these publications have impacted the utilization of adjuvant therapies and whether their survival benefits were evident in contemporary cohort of patients. Methods: Using the National Cancer Data Base, we identified 5,029 patients diagnosed with T1-3N0-1 GBC and treated with surgical resection from 2005 to 2013. We described trends in receipt of adjuvant treatments for three time periods (2005-2007, 2008-2010, 2011-2013) and calculated 3-year overall survival (OS) probabilities for 2,989 patients treated in 2005-2010. Results: The percentage of patients who received no adjuvant treatment was unchanged from 2005 to 2013. Adjuvant RT decreased from 4.3% to 1.7% (p < 0.01), adjuvant chemotherapy increased from 8% to 14% (p < 0.01), and adjuvant CRT remained stable at 16% (p = 0.98). Even for locally advanced disease (T3N0 and T1-3N1) or in the setting of positive resection margins, over 50% of patients in US did not receive adjuvant treatments. Adjuvant treatments were associated with improved 3-year overall survival in patients with resected GBC, as listed in Table. Adjuvant CRT was associated with improved survival in all stages, except T1N0, and in patients with negative and positive margins. Conclusions: Over the past decade there was no increase in the utilization of adjuvant therapies in the US for patients with resected GBC. Adjuvant therapy is associated with significantly improved 3-yr OS. In the absence of randomized data, this analysis should form the basis for clinical recommendations and national guidelines should be amended to support adjuvant treatment.[Table: see text]

Adjuvant Therapy Use and Survival in Stage II Endometrial Cancer

2017 ◽  
Vol 27 (9) ◽  
pp. 1904-1911 ◽  
Author(s):  
Nataniel H. Lester-Coll ◽  
Melissa R. Young ◽  
Henry S. Park ◽  
Elena S. Ratner ◽  
Babak Litkouhi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Confidence Interval ◽  
Data Base ◽  
Adjuvant Treatment ◽  
Odds Ratio ◽  
National Cancer Data Base ◽  
Stage Ii ◽  
Cancer Data

ObjectiveRadiotherapy (RT) is an established adjuvant treatment for stage II endometrioid endometrial carcinoma (EEC). The role of chemotherapy (CT) in stage II EEC is less proven. We used the National Cancer Data Base to identify factors associated with adjuvant CT in stage II EEC and to explore whether receipt of CT was associated with improved overall survival (OS).Methods/MaterialsWomen diagnosed in 2010 to 2013 with International Federation of Obstetrics and Gynecology stage II EEC (grades 1–3) after hysterectomy and bilateral salpingo-oophorectomy were identified in the National Cancer Data Base. Multivariable logistic regression was used to identify covariates associated with receipt of CT. Overall survival among patients receiving RT, CT, or chemoradiotherapy (CRT) after surgery was compared using Kaplan-Meier estimates, the log-rank test, Cox proportional hazards regression, and propensity score matching.ResultsWe identified 6102 stage II EEC patients. There were 358 patients (6%) who received adjuvant CT alone and 525 (9%) who received CRT; the remainder received RT alone (n = 1906; 31%) or no adjuvant treatment (n = 3313; 54%). The presence of lymphovascular invasion (odds ratio, 3.58;P< 0.001) and grade 3 disease (odds ratio, 3.40;P< 0.001) was strongly associated with receipt of CT or CRT. The OS at 3 years for the entire cohort was 89%. On multivariable analysis, CT versus RT was associated with worse OS (hazard ratio [HR], 2.12 [95% confidence interval, 1.46–3.06];P< 0.001), whereas CRT versus RT was not associated with improved OS (HR, 1.07 [95% confidence interval, 0.71–1.62];P= 0.781). After propensity score matching, there remained no difference in OS between RT and CRT (HR, 1.14;P= 0.614).ConclusionsPatients with stage II EEC have an excellent prognosis, and most undergo observation or receive adjuvant RT in the United States. Receipt of CT (alone or with RT) was not associated with an OS advantage compared with RT alone in this observational cohort. Randomized trials will help clarify the role of CT in stage II patients.

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