The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors

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.

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Protective effect of early low-dose hydrocortisone on ventilator-associated pneumonia in the cancer patients: a propensity score analysis

Annals of Intensive Care ◽

10.1186/s13613-017-0329-7 ◽

2017 ◽

Vol 7 (1) ◽

Author(s):

David Lagier ◽

Laura Platon ◽

Jérome Lambert ◽

Laurent Chow-Chine ◽

Antoine Sannini ◽

...

Keyword(s):

Propensity Score ◽

Protective Effect ◽

Cancer Patients ◽

Low Dose ◽

Propensity Score Analysis ◽

Ventilator Associated Pneumonia ◽

Score Analysis

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Is Preoperative Fibrinogen Associated with the Survival Prognosis of Gastric Cancer Patients? A Multi-centered, Propensity Score-Matched Retrospective Study

World Journal of Surgery ◽

10.1007/s00268-019-05191-9 ◽

2019 ◽

Vol 44 (1) ◽

pp. 213-222

Author(s):

Lin-Yong Zhao ◽

Yong-Liang Zhao ◽

Jun-Jiang Wang ◽

Qi-Di Zhao ◽

Wen-Qi Yi ◽

...

Keyword(s):

Gastric Cancer ◽

Propensity Score ◽

Cancer Patients ◽

Prognostic Significance ◽

Staging System ◽

Tnm Staging ◽

Plasma Fibrinogen ◽

Tnm Staging System ◽

N Stage ◽

Gastric Cancer Patients

Abstract Background The prognostic significance of preoperative plasma fibrinogen in patients with operable gastric cancer remains under debate. This study aimed to elucidate the prognostic value of fibrinogen in gastric cancer patients underwent gastrectomy. Methods A total of 4351 patients with gastric cancer collected from three comprehensive medical centers were retrospectively evaluated. Patients were categorized by minimum P value using X-tile, while the baseline confounders for fibrinogen was balanced through propensity score matching (PSM). The relationships between fibrinogen and other clinicopathologic features were evaluated, and nomogram was constructed to assess its prognostic improvement compared with TNM staging system. Results Fibrinogen was significantly correlated with macroscopic type, tumor differentiation, tumor size, and T and N stage. The factors, fibrinogen and T stage as well as N stage, were identified to be independent prognostic factors after PSM. Nomogram based on fibrinogen demonstrated a smaller Akaike information criterion (AIC) and a larger concordance index (C-index) than TNM staging system, illustrating that fibrinogen might be able to improve the prognostic accuracy. Conclusions Preoperative plasma fibrinogen levels in gastric cancer patients were significantly correlated with tumor progression, which could be regarded as a reliable marker for survival prognostic prediction.

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