Improved oncologic outcomes for minimally invasive left pancreatectomy: Propensity‐score matched analysis of the National Cancer Database

2020 ◽  
Vol 122 (7) ◽  
pp. 1383-1392
Author(s):  
Michael D. Watson ◽  
Maria R. Baimas‐George ◽  
Kyle J. Thompson ◽  
David A. Iannitti ◽  
Lee M. Ocuin ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Oncologic Outcomes ◽  
National Cancer Database ◽  
Left Pancreatectomy

A Single Institution Propensity Score Weighted Analysis of Time to Chemotherapy After Minimally Invasive Versus Open Colorectal Surgery

2021 ◽  
pp. 000313482110111
Author(s):  
Samik H. Patel ◽  
Michael A. Battaglia ◽  
Beth-Ann Shanker ◽  
Robert K. Cleary
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Hospital Length Of Stay ◽  
Oncologic Outcomes ◽  
Surgical Approaches ◽  
Time Interval ◽  
Study Objective ◽  
Propensity Score Weighting ◽  
Significant Difference ◽  
The Impact

Background Oncologic outcomes for colon cancer are optimal when chemotherapy is started within 6 to 8 weeks after surgery. The study objective was to investigate the impact of operative modality and urgency on the time interval from surgery to adjuvant chemotherapy. Methods This is a retrospective institutional tumor registry cohort study of open and laparoscopic/robotic colorectal resections for stage II-IV cancer between April 2010 and January 2018. Primary outcome was time from surgery to chemotherapy. Predictor variables were adjusted for imbalances by propensity score weighting. Results A total of 220 patients met inclusion criteria: 171 elective (108 laparoscopic/robotic and 63 open) and 49 urgent colectomies. After propensity score weighting, there was no significant difference in time to chemotherapy between elective minimally invasive and open surgical approaches (48 days vs. 58 days, P = .187). Only 68.9% of minimally invasive and 50.8% of open colectomy patients started chemotherapy within 8 weeks of surgery. There was a significant difference ( P = .037) among surgical sites with rectal resections having the longest (55 days), and right colectomies having the shortest (46 days), time to chemotherapy. Patients who had urgent operations had significantly longer hospital length of stay ( P < .001) and higher post-discharge emergency department visit rates ( P < .001) than the elective operation group. However, there was no significant difference in time to chemotherapy. Discussion Neither operative modality nor operative urgency resulted in a significant difference in postoperative time to initiating chemotherapy. Future efforts should be focused on identifying postoperative recovery criteria and optimum multidisciplinary communication methods that allow recovered patients to start chemotherapy sooner.

Minimally Invasive Mastectomy Could Achieve Non-inferior Oncological Outcome in Appropriately Selected Patients: Propensity Matched Analysis of the National Cancer Database

2021 ◽  
pp. 000313482110111
Author(s):  
Lifen Cao ◽  
Robert Shenk ◽  
Megan E. Miller ◽  
Christopher Towe
Keyword(s):  
Minimally Invasive ◽  
Oncological Outcome ◽  
Oncologic Outcomes ◽  
National Cancer Database ◽  
Breast Cancer Patients ◽  
Propensity Match ◽  
Additional Approach ◽  
Cox Proportional Hazard Regression ◽  
Nipple Sparing

Background Minimally invasive mastectomy (MIM) was emerged as an approach to decrease morbidity and increase patient satisfaction through improved cosmetic results; however, there is a paucity of data regarding the long-term oncologic outcomes of these minimally invasive approaches. Methods Patients who underwent mastectomy procedures were identified in the National Cancer Database (2010-2016). Patients were categorized as MIM or open mastectomy. A 1:1 propensity match was performed to balance the bias on reconstruction, nipple sparing, lymph node procedures, and other confounding factors between the cohorts. Short- and long-term outcomes were compared. Results A total of 328 811 patients met the criteria: 327 643 (99.6%) received open mastectomy and 1168 (.4%) received MIM. Propensity match identified 384 “pairs” of MIM and open mastectomy patients. Among them, MIM was associated with shorter length of stay (LOS) (mean 1.3 vs. 1.06 days, P = .003). No differences were observed in the rates of positive margins, unplanned readmissions, or 90-day mortality between the 2 operative approaches. Overall survival (OS) was equivalent between MIM and open mastectomy patients. Cox proportional hazard regression showed no effect of the procedure performed on OS. Discussion MIM is associated with shorter LOS, and it is non-inferior to open mastectomy in terms of other short-term outcomes and long-term oncologic survival outcomes. These data suggest that MIM may be considered in appropriately selected breast cancer patients as an additional approach to the community.

scholarly journals The effect of adjuvant radiotherapy on overall survival in adults with intracranial ependymoma

2019 ◽  
Vol 7 (4) ◽  
pp. 391-399
Author(s):  
Roshan S Prabhu ◽  
Christopher D Corso ◽  
Matthew C Ward ◽  
John H Heinzerling ◽  
Reshika Dhakal ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Adjuvant Radiotherapy ◽  
Subtotal Resection ◽  
National Cancer Database ◽  
Risk Of Death ◽  
Increased Risk ◽  
Intracranial Ependymoma ◽  
Male Sex ◽  
Grade 3

Abstract Background Adult intracranial ependymoma is rare, and the role for adjuvant radiotherapy (RT) is not well defined. Methods We used the National Cancer Database (NCDB) to select adults (age ≥ 22 years) with grade 2 to 3 intracranial ependymoma status postresection between 2004 and 2015 and treated with adjuvant RT vs observation. Four cohorts were generated: (1) all patients, (2) grade 2 only, (3) grade 2 status post–subtotal resection only, (4) and grade 3 only. The association between adjuvant RT use and overall survival (OS) was assessed using multivariate Cox and propensity score matched analyses. Results A total of 1787 patients were included in cohort 1, of which 856 patients (48%) received adjuvant RT and 931 (52%) were observed. Approximately two-thirds of tumors were supratentorial and 80% were grade 2. Cohorts 2, 3, and 4 included 1471, 345, and 316 patients, respectively. There was no significant association between adjuvant RT use and OS in multivariate or propensity score matched analysis in any of the cohorts. Older age, male sex, urban location, higher comorbidity score, earlier year of diagnosis, and grade 3 were associated with increased risk of death. Conclusions This large NCDB study did not demonstrate a significant association between adjuvant RT use and OS for adults with intracranial ependymoma, including for patients with grade 2 ependymoma status post–subtotal resection. The conflicting results regarding the efficacy of adjuvant RT in this patient population highlight the need for high-quality studies to guide therapy recommendations in adult ependymoma.

scholarly journals Minimally invasive ileal pouch-anal anastomosis for patients with obesity: a propensity score-matched analysis

2021 ◽  
Author(s):  
Mohamed A. Abd El Aziz ◽  
Giacomo Calini ◽  
Fabian Grass ◽  
Kevin T. Behm ◽  
Anne-Lise D’ Angelo ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Ileal Pouch ◽  
Ileal Pouch Anal Anastomosis ◽  
Anal Anastomosis

Primary Surgical Treatment in Very Advanced (T4b) Oral Cavity Squamous Cell Carcinomas

2021 ◽  
pp. 019459982098435
Author(s):  
Evan J. Patel ◽  
Jamie R. Oliver ◽  
Alec Vaezi ◽  
Zujun Li ◽  
Michael Persky ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Propensity Score ◽  
Oral Cavity ◽  
Squamous Cell ◽  
Multivariable Analysis ◽  
Group Versus ◽  
Curative Treatment ◽  
National Cancer Database ◽  
Curative Intent ◽  
Historical Cohort

Objectives To describe patterns of primary surgical treatments in patients with T4b oral cavity squamous cell carcinoma (OCSCC). Study Design Historical cohort study. Setting National Cancer Database. Methods Review of the National Cancer Database between 2004 and 2017 for all T4b OCSCCs. Only patients with curative treatment methods were included in the survival analysis. Surgical and nonsurgical outcomes were compared by multivariable and propensity score matching analysis. Results A total of 1515 cases of T4b OCSCC were identified. A minority of patients (n = 363, 24.0%) underwent curative treatment; among these, 206 (56.7%) underwent primary surgery. Median length of follow-up was 24 months. The 90-day mortality of patients who underwent surgical treatment was 1.0%. The 2-year survival was higher for patients who underwent surgery + chemoradiotherapy (CRT) as compared with CRT (64.6% vs 45.2%, P < .001). On multivariable analysis, surgery + CRT was associated with longer survival. In a propensity score–matched cohort of 312 patients, 2-year survival remained higher in the surgical group versus the nonsurgical group (59.4% vs 45.5%, P = .02). Among patients who underwent surgery + CRT, there was no difference in 2-year survival between clinical T4a and T4b (59% vs 64.6%, P = .20). Conclusions A minority of patients with T4b OCSCC undergo treatments with curative intent. A subset of patients underwent primary surgical treatment, which was associated with longer survival. The T4b classification might entail a heterogenous group, and further studies in revision of this classification might be justified.

Systematic review of perioperative and oncologic outcomes of minimally-invasive surgery for hilar cholangiocarcinoma

2021 ◽  
Vol 73 (2) ◽  
pp. 359-377
Author(s):  
Federica Cipriani ◽  
Francesca Ratti ◽  
Guido Fiorentini ◽  
Raffaella Reineke ◽  
Luca Aldrighetti
Keyword(s):  
Systematic Review ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Hilar Cholangiocarcinoma ◽  
Oncologic Outcomes

scholarly journals Comparison of Oncologic Outcomes between Carbon Ion Radiotherapy and Stereotactic Body Radiotherapy for Early-Stage Non-Small Cell Lung Cancer

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 176
Author(s):  
Yuhei Miyasaka ◽  
Shuichiro Komatsu ◽  
Takanori Abe ◽  
Nobuteru Kubo ◽  
Naoko Okano ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Stereotactic Body Radiotherapy ◽  
Early Stage ◽  
Small Cell ◽  
Oncologic Outcomes ◽  
Comparison Study ◽  
Small Cell Lung ◽  
Early Stage Nsclc

Lung cancer is a leading cause of cancer-related deaths worldwide. Radiotherapy is an essential treatment modality for inoperable non-small cell lung cancer (NSCLC). Stereotactic body radiotherapy (SBRT) is the standard treatment for early-stage NSCLC because of its favorable local control (LC) compared to conventional radiotherapy. Carbon ion radiotherapy (CIRT) is a kind of external beam radiotherapy characterized by a steeper dose distribution and higher biological effectiveness. Several prospective studies have shown favorable outcomes. However, there is no direct comparison study between CIRT and SBRT to determine their benefits in the management of early-stage NSCLC. Thus, we conducted a retrospective, single-institutional, and contemporaneous comparison study, including propensity score-adjusted analyses, to clarify the differences in oncologic outcomes. The 3-year overall survival (OS) was 80.1% in CIRT and 71.6% in SBRT (p = 0.0077). The 3-year LC was 87.7% in the CIRT group and 79.1% in the SBRT group (p = 0.037). Multivariable analyses showed favorable OS and LC in the CIRT group (hazard risk [HR] = 0.41, p = 0.047; HR = 0.30, p = 0.040, respectively). Log-rank tests after propensity score matching and Cox regression analyses using propensity score confirmed these results. These data provided a positive efficacy profile of CIRT for early-stage NSCLC.

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

2021 ◽  
Vol 91 (4) ◽  
Author(s):  
Ken Min Chin ◽  
Yun‐Le Linn ◽  
Chin Kai Cheong ◽  
Ye‐Xin Koh ◽  
Jin‐Yao Teo ◽  
...  
Keyword(s):  
Propensity Score ◽  
Minimally Invasive ◽  
Liver Malignancies ◽  
Central Hepatectomy
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