scholarly journals Effects of Surgery on Survival of Early-Stage Patients With SCLC: Propensity Score Analysis and Nomogram Construction in SEER Database

2020 ◽  
Vol 10 ◽  
Author(s):  
Yuyan Wang ◽  
Qiwen Zheng ◽  
Bo Jia ◽  
Tongtong An ◽  
Jun Zhao ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Seer Database ◽  
Score Analysis

Breast-Conserving Therapy is Associated with Better Survival than Mastectomy in Early-Stage Breast Cancer: A Propensity Score Analysis

2021 ◽  
Author(s):  
Jiali Ji ◽  
Shushu Yuan ◽  
Jiawei He ◽  
Hong Liu ◽  
Lei Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Breast Conserving Therapy ◽  
Early Stage Breast Cancer ◽  
Breast Cancer Patients ◽  
Kaplan Meier ◽  
Score Analysis

Abstract Background: Recent retrospective studies have reported that breast-conserving therapy (BCT) led to improved overall survival (OS) than mastectomy in some populations. We aimed to compare the efficacy of BCT and mastectomy using the SEER database. Methods: Between 2010 and 2015, 99,790 eligible patients were identified. We included early-stage breast cancer patients with 5cm or smaller tumors and three or fewer positive lymph nodes in our study. We compared the OS results among patients with BCT and mastectomy. Kaplan-Meier plots, Cox proportional hazard regressions were used to evaluate the outcomes. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: In our study, 77,452 (77.6%) patients underwent BCT and 22,338 (22.4%) underwent mastectomy. The 5-year OS rate was 94.7% in the BCT group and 87.6% in the mastectomy group (P <0.001). After matching, multivariate analysis in the matched cohort showed that women underwent mastectomy was associated with worse OS results compared with those with BCT (Hazard ratio (HR) = 1.628; 95% confidence intervals (CIs) = 1.445- 1.834, P<0.001). Patients with different subtypes and age group (>50 years old; ≤50 years old) received BCT all showed significantly better OS than those received mastectomy. The effect of surgery choice on survival was the same in matched and all cohorts. Conclusions: Our study showed that BCT was associated with improved survival compared with mastectomy in early-stage breast cancer patients. It seems advisable to encourage patients to receive BCT rather than mastectomy in early-stage patients when feasible and appropriate.

Surgical resection versus radiofrequency ablation very early‐stage HCC (≤2 cm Single HCC): A propensity score analysis

2019 ◽  
Vol 39 (12) ◽  
pp. 2397-2407 ◽  
Author(s):  
Hee Ho Chu ◽  
Jin Hyoung Kim ◽  
Pyo Nyun Kim ◽  
So Yeon Kim ◽  
Young‐Suk Lim ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Propensity Score ◽  
Surgical Resection ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Score Analysis

scholarly journals Benefit of Cisplatin With Definitive Radiotherapy in Older Women With Cervical Cancer

2019 ◽  
Vol 17 (8) ◽  
pp. 969-975
Author(s):  
Michael Xiang ◽  
Elizabeth A. Kidd
Keyword(s):  
Cervical Cancer ◽  
Propensity Score ◽  
Older Women ◽  
Competing Risks ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Disease Incidence ◽  
Early Stage Disease ◽  
Definitive Radiotherapy ◽  
Score Analysis

Background: Cisplatin with definitive radiotherapy (RT) is considered the standard of care for cervical cancer; however, older women are frequently undertreated and have worse outcomes compared with younger patients. Because women aged ≥65 years have been disproportionately underrepresented in clinical trials, uncertainties exist regarding how much they benefit from the addition of cisplatin to RT. Patients and Methods: Women aged ≥65 years with nonmetastatic cervical cancer treated with definitive external-beam RT and brachytherapy were identified in the SEER-Medicare database. Death attributable to cervical cancer (cancer-specific mortality [CSM]) was evaluated against competing risks of death using Gray’s test. Propensity score analysis and the Fine-Gray multivariable regression model were used to adjust for baseline differences, including comorbidity. Results: The total cohort comprised 826 patients, of whom 531 (64%) received cisplatin, 233 (28%) were FIGO stage I, 374 (45%) were stage II, and 219 (27%) were stage III–IVA. Older age and chronic kidney disease significantly predicted omission of cisplatin. Virtually all cisplatin dosing was weekly, with a median of 5 cycles. Death from cervical cancer was significantly lower with cisplatin than without (5-year CSM, 31% vs 39%; P=.02; adjusted hazard ratio, 0.72; P=.02), which persisted in propensity score analysis. Receiving ≥5 cycles was required for benefit, as no difference in CSM was seen in patients receiving 1 to 4 cycles versus no cisplatin. Subgroup analyses revealed that the benefit of cisplatin persisted in women aged ≥75 years and those with early-stage disease. Incidence of cytopenia, nausea/vomiting, and hypovolemia increased in patients treated with cisplatin. Conclusions: Administration of cisplatin with definitive RT in women aged ≥65 years was associated with a significant benefit in the incidence of death attributable to cervical cancer, despite competing risks for mortality in an older population. Receiving at least 5 cycles of weekly cisplatin was required for benefit.

A propensity score analysis exploring the impact of adjuvant chemotherapy (aCT) in a multi-center series of resected early stage pure invasive lobular breast carcinoma (ILC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 539-539
Author(s):  
Luisa Carbognin ◽  
Isabella Sperduti ◽  
Grazia Arpino ◽  
Maria Vittoria Dieci ◽  
Francesco Schettini ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Early Stage ◽  
Cox Model ◽  
Absolute Difference ◽  
Prognostic Impact ◽  
Term Survival ◽  
Score Analysis ◽  
The Impact ◽  
N Status

539 Background: Patients (pts) resected for early breast cancer are assigned to receive aCT according to international guidelines based upon immunophenotype and clinical/pathological features, regardless of the histotype, given the lack of prospective data for ILC. Thus, the magnitude of the benefit of aCT for ILC is still not sizable. The aim of this analysis was to investigate the effect of aCT in a multi-center series of early stage pure ILC. Methods: Clinical-pathological data of consecutive pts affected by pure ILC, undergone surgery at 3 Italian institutes, were correlated with disease-free and overall survival (DFS/OS) using a Cox model. A propensity score analysis was performed to evaluate the prognostic impact of aCT. Kaplan-Meier curves were compared with Log-Rank analysis. Results: Data from 739 pts were gathered (median age 57 years (yrs); Luminal/Triple-Negative/HER2 pos.: 98%/1.6%/0.4%). At median follow-up of 78 months, 5-/10-yrs DFS and OS were 79.4%/66.0% and 91.4%/76.5%, respectively. Tumor-size according to TNM (T, HR 1.34, 95% CI 1.04-1.72, p=0.025) and lymph-node (N) status (HR 2.39, 95% CI 1.47-3.89, p<0.0001) were independent predictors for DFS at multivariate analysis. T (HR 1.87, 95% CI 0.99-3.54, p=0.05), N status (HR 3.24, 95% CI 1.69-6.22, p<0.0001), Ki67 (HR 2.48, 95% CI 0.95-6.42, p=0.06), and age (HR 2.23, 95% CI 1.16-4.30, p=0.016) were predictors for OS. A significant prognostic effect of aCT upon OS was found after adjusting for independent factors with the propensity score method, as shown in the table below. Particularly, aCT significantly prolongs OS and DFS in pts with T >1, with an absolute difference of 17%/35% and 15%/13% at 5 and 10 yrs, respectively ( p=0.003 and p=0.04). OS was longer for pts with positive N ( p=0.02), Ki67 >4% ( p=0.01) and grading >1 ( p=0.01). Conclusions: Despite the retrospective nature of this analysis, the propensity score analysis indicates that pts with ILC may significantly benefit from aCT in terms of long-term survival, particularly for larger and more aggressive tumors. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document