scholarly journals Evaluation of the prognostic relevance of the recommended minimum number of lymph nodes in colorectal cancer—a propensity score analysis

2021 ◽  
Author(s):  
Michaela Ramser ◽  
Leonard A. Lobbes ◽  
Rene Warschkow ◽  
Carsten T. Viehl ◽  
Johannes C. Lauscher ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cox Regression ◽  
Propensity Score Analysis ◽  
Disease Free Survival ◽  
Stage I ◽  
Score Analysis ◽  
Minimum Number ◽  
The Impact

Abstract Purpose Nodal status in colorectal cancer (CRC) is an important prognostic factor, and adequate lymph node (LN) staging is crucial. Whether the number of resected and analysed LN has a direct impact on overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS) is much discussed. Guidelines request a minimum number of 12 LN to be analysed. Whether that threshold marks a prognostic relevant cut-off remains unknown. Methods Patients operated for stage I–III CRC were identified from a prospectively maintained database. The impact of the number of analysed LN on OS, CSS and DFS was assessed using Cox regression and propensity score analysis. Results Of the 687 patients, 81.8% had ≥ 12 LN resected and analysed. Median LN yield was 17.0 (IQR 13.0–23.0). Resection and analysis of ≥ 12 LN was associated with improved OS (HR = 0.73, 95% CI: 0.56–0.95, p = 0.033), CSS (HR 0.52, 95% CI: 0.31–0.85, p = 0.030) and DFS (HR = 0.73, 95% CI: 0.57–0.95, p = 0.030) in multivariate Cox analysis. After adjusting for biasing factors with propensity score matching, resection of ≥ 12 LN was significantly associated with improved OS (HR = 0.59; 95% CI: 0.43–0.81; p = 0.002), CSS (HR = 0.34; 95% CI: 0.20–0.60; p < 0.001) and DFS (HR = 0.55; 95% CI: 0.41–0.74; p < 0.001) compared to patients with < 12 LN. Conclusion Eliminating biasing factors by a propensity score matching analysis underlines the prognostic importance of the number of analysed LN. The set threshold marks the minimum number of required LN but nevertheless represents a cut-off regarding outcome in stage I–III CRC. This analysis therefore highlights the significance and importance of adherence to surgical oncological standards.

Role of adjuvant radiation therapy in ampullary carcinoma: Propensity-score matched SEER analysis.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 282-282
Author(s):  
John Byun ◽  
Surbhi Grover ◽  
Lauren Michelle Hertan ◽  
Smith Apisarnthanarax
Keyword(s):  
Radiation Therapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Survival Benefit ◽  
Propensity Score Analysis ◽  
Ampullary Cancer ◽  
Survival Outcomes ◽  
Score Analysis ◽  
The Impact

282 Background: Ampullary cancer outcomes have been reported to compare favorably with pancreatic and biliary malignancies. Consensus guidelines on the optimal adjuvant management after resection in these patients remain unclear. Propensity score matching was used to compare the outcomes of patients with ampullary cancer receiving or not receiving radiation therapy (RT) from the Surveillance, Epidemiology, and End Results (SEER) database. Methods: Patients with a diagnosis of ampulla of vater carcinoma who underwent curative intent surgery were identified within 17 SEER registries from 1998-2008. Patients with M1 disease or follow up less than 5 months were excluded. Data on patient characteristics such as age at diagnosis, race, tumor characteristics including TNM staging and histologic subtype, and survival outcomes were extracted and compared between patients who received adjuvant RT and those who did not. Propensity score matching was used to minimize treatment selection bias within the specified characteristics and estimate the impact of RT on median survival times (MST). Matching algorithms used validated Mahalanobis nearest neighbor methods based on conditional probabilities of receiving RT. Results: Of the 1782 patients identified, 490 (25%) were treated with adjuvant RT: 318 (65%) T3/4 and 333 (68%) N1. Cox regression with propensity score analysis for patients with RT showed an overall decrease in survival time by 3.67 months (p<0.05). Propensity score analysis showed slightly worse survival in patients who received RT compared to those who did not (MST 2.7 vs. 3.0 years, respectively, p=0.04). There was a trend towards a survival benefit with RT in a subgroup of patients over the age of 66 years with T2N0 tumors (MST 4.7 vs. 2.7 years, respectively, p=0.14). Survival outcomes analyzed by other T and N stages were not statistically significant. Conclusions: Adjuvant RT does not confer a survival benefit in resected ampullary cancers as studied in the propensity-score adjusted SEER patient population. Further studies should be conducted in order to elucidate the role of adjuvant RT for ampullary cancers.

scholarly journals Burden of motorcyclists without helmets in a state without a universal helmet law: a propensity score analysis

2020 ◽  
Vol 5 (1) ◽  
pp. e000583
Author(s):  
Michael D Jones ◽  
Joel G Eastes ◽  
Damjan Veljanoski ◽  
Kristina M Chapple ◽  
James N Bogert ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Analysis ◽  
Alcohol Intoxication ◽  
Civil Liberties ◽  
Hospital Charges ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Helmet Use ◽  
Score Analysis ◽  
The Impact

BackgroundAlthough helmets are associated with reduction in mortality from motorcycle collisions, many states have failed to adopt universal helmet laws for motorcyclists, in part on the grounds that prior research is limited by study design (historical controls) and confounding variables. The goal of this study was to evaluate the association of helmet use in motorcycle collisions with hospital charges and mortality in trauma patients with propensity score analysis in a state without a universal helmet law.MethodsMotorcycle collision data from the Arizona State Trauma Registry from 2014 to 2017 were propensity score matched by regressing helmet use on patient age, sex, race/ethnicity, alcohol intoxication, illicit drug use, and comorbidities. Linear and logistic regression models were used to evaluate the impact of helmet use.ResultsOur sample consisted of 6849 cases, of which 3699 (54.0%) were helmeted and 3150 (46.0%) without helmets. The cohort was 88.1% male with an average age of 40.9±16.0 years. Helmeted patients were less likely to be admitted to the intensive care unit (20.3% vs. 23.7%, OR 0.82 (0.72–0.93)) and ventilated (7.8% vs. 12.0%, OR 0.62 (0.52–0.75)). Propensity-matched analyses consisted of 2541 pairs and demonstrated helmet use to be associated with an 8% decrease in hospital charges (B −0.075 (0.034)) and a 56% decrease in mortality (OR 0.44 (0.31–0.58)).DiscussionIn a state without mandated helmet use for all motorcyclists, the burden of the unhelmeted rider is significant with respect to lives lost and healthcare charges incurred. Although the helmet law debate with respect to civil liberties is complex and unsettled, it appears clear that helmet use is strongly associated with both survival and less economic encumbrance on the state.Level of evidenceLevel III, prognostic and epidemiological.

scholarly journals Lobe-Specific Nodal Dissection for Clinical Stage I and II NSCLC: Japanese Multi-Institutional Retrospective Study Using a Propensity Score Analysis

2016 ◽  
Vol 11 (9) ◽  
pp. 1529-1537 ◽  
Author(s):  
Tomoyuki Hishida ◽  
Etsuo Miyaoka ◽  
Kohei Yokoi ◽  
Masahiro Tsuboi ◽  
Hisao Asamura ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Clinical Stage ◽  
Stage I ◽  
Score Analysis ◽  
Nodal Dissection

scholarly journals Propensity score analysis exploring the impact of smoking and drinking on the prognosis of patients with oral cancer

Head & Neck ◽  
2020 ◽  
Vol 42 (8) ◽  
pp. 1837-1847 ◽  
Author(s):  
Xiaodan Bao ◽  
Fengqiong Liu ◽  
Qing Chen ◽  
Lin Chen ◽  
Jing Lin ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Propensity Score ◽  
Propensity Score Analysis ◽  
Score Analysis ◽  
The Impact

The impact of preoperative dexamethasone on long-term survival following surgery for colorectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 644-644
Author(s):  
Stephen Thomas McSorley ◽  
Bo Khor ◽  
Campbell SD Roxburgh ◽  
Paul G. Horgan ◽  
Donald C McMillan
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Cox Regression ◽  
Elective Surgery ◽  
Matched Cohort ◽  
Curative Intent ◽  
Term Survival ◽  
Negative Effect ◽  
The Impact

644 Background: Steroids given at the induction of anaesthesia are associated with a reduction in the magnitude of the postoperative systemic inflammatory response and fewer complications following elective surgery for colorectal cancer (McSorley et al. Ann Surg Oncol 2017;24(8):2104-2112). The present study examined their impact on survival. Methods: Patients who underwent elective surgery, with curative intent, for stage I-III colorectal cancer at a single centre between 2008 and 2016 were included. Data on preoperative dexamethasone was obtained from anaesthetic records, and its impact on cancer specific (CSS) and overall survival (OS) assessed using Cox regression in an unmatched (n=556) and a propensity score matched cohort (n=276) (Table 1). Results: After excluding postoperative mortalities (n=3), there were 98 deaths (18%), with 57 (10%) due to cancer. Of those alive at censoring, the median follow up was 47 months (range 16-110). In the unmatched cohort, there was no significant association between dexamethasone and CSS (HR 0.90, 95% CI 0.52-1.53, p=0.688) or OS (HR 0.95, 95% CI 0.63-1.43, p=0.804). In the propensity score matched cohort, there was no significant association between dexamethasone and CSS (HR 1.18, 95% CI 0.55-2.53, p=0.668) or OS (HR 1.21, 95% CI 0.67-2.17), p=0.532). Conclusions: These results suggest that whilst preoperative steroids are associated with improved short term outcomes following surgery for colorectal cancer, they have no negative effect on long term outcomes. [Table: see text]

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