Recent Trends in Vestibular Schwannoma Management: An 11-Year Analysis of the National Cancer Database

2019 ◽  
Vol 161 (1) ◽  
pp. 137-143 ◽  
Author(s):  
Solymar Torres Maldonado ◽  
James G. Naples ◽  
Ramie Fathy ◽  
Steven J. Eliades ◽  
John Y. K. Lee ◽  
...  
Keyword(s):  
United States ◽  
Vestibular Schwannoma ◽  
Tumor Size ◽  
The United States ◽  
Treatment Center ◽  
National Cancer Database ◽  
Strong Shift ◽  
Primary Surgery ◽  
Recent Trends ◽  
Average Tumor Size

ObjectiveA better understanding of the natural history of vestibular schwannoma (VS) has resulted in a change in treatment paradigms. It has also been proposed that increased use of high-resolution magnetic resonance imaging has allowed for an increased identification of small tumors. The aim of this study was to evaluate recent trends in the presentation and primary management of VS in the United States.Study DesignRetrospective analysis of the National Cancer Database (NCDB).SettingNCDB database.Subjects and MethodsAll patients with a diagnosis of VS between 2004 and 2014 were included. Data were analyzed with univariable and multivariable logistic regression.ResultsIn total, 28,190 patients (mean age 55 years, 52.9% female) with VS were analyzed. Linear regression showed a small decrease in average tumor size over time (–0.06 mm/year, P = .03). Overall, 11,121 patients (40%) received surgery, 8512 (30%) radiation, and 7686 (27%) observation. Controlling for patient, tumor, and treatment center factors, the odds ratio (OR) for receiving surgery in 2014 was 0.60 (confidence interval [CI], 0.50-0.71) while the OR for receiving radiation was 0.75 (CI, 0.64-0.87) as compared to those diagnosed in 2004. The largest increases in observation rates occurred among tumors ≤2 cm ( P < .001).ConclusionThere was not a clinically significant change in the average tumor size at diagnosis. Although surgery remained the most common treatment modality in the United States, there was a strong shift in the management of VS away from primary surgery and radiation and toward a “wait-and-scan” approach.

Nonmalignant meningioma and vestibular schwannoma incidence trends in the United States, 2004‐2017

Cancer ◽  
2021 ◽  
Author(s):  
Diana R. Withrow ◽  
Susan S. Devesa ◽  
Dennis Deapen ◽  
Valentina Petkov ◽  
Alison L. Van Dyke ◽  
...  
Keyword(s):  
United States ◽  
Vestibular Schwannoma ◽  
The United States ◽  
Incidence Trends

scholarly journals Racial Differences in Incident Genitourinary Cancer Cases Captured in the National Cancer Database

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 671
Author(s):  
Dylan T. Wolff ◽  
Thomas F. Monaghan ◽  
Danielle J. Gordon ◽  
Kyle P. Michelson ◽  
Tashzna Jones ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Bladder Cancer ◽  
Kidney Cancer ◽  
The United States ◽  
Coverage Rate ◽  
National Cancer Database ◽  
Genitourinary Cancer ◽  
Coverage Rates ◽  
Capture Rates

Background and Objectives: The National Cancer Database (NCDB) captures nearly 70% of all new cancer diagnoses in the United States, but there exists significant variation in this capture rate based on primary tumor location and other patient demographic factors. Prostate cancer has the lowest coverage rate of all major cancers, and other genitourinary malignancies likewise fall below the average NCDB case coverage rate. We aimed to explore NCDB coverage rates for patients with genitourinary cancers as a function of race. Materials and Methods: We compared the incidence of cancer cases in the NCDB with contemporary United States Cancer Statistics data. Results: Across all malignancies, American Indian/Alaskan Natives subjects demonstrated the lowest capture rates, and Asian/Pacific Islander subjects exhibited the second-lowest capture rates. Between White and Black subjects, capture rates were significantly higher for White subjects overall and for prostate cancer and kidney cancer in White males, but significantly higher for bladder cancer in Black versus White females. No significant differences were observed in coverage rates for kidney cancer in females, bladder cancer in males, penile cancer, or testicular cancer in White versus Black patients. Conclusions: Differential access to Commission on Cancer-accredited treatment facilities for racial minorities with genitourinary cancer constitutes a unique avenue for health equity research.

scholarly journals Recent trends in breast surgery in the United States and United Kingdom.

BMJ ◽  
1986 ◽  
Vol 292 (6534) ◽  
pp. 1487-1491 ◽  
Author(s):  
E R Greenberg ◽  
M Stevens
Keyword(s):  
United States ◽  
United Kingdom ◽  
Breast Surgery ◽  
The United States ◽  
Recent Trends

Recent Trends in Clinical Outcomes and Resource Utilization for Pulmonary Embolism in the United States

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 983-990 ◽  
Author(s):  
Brian Park ◽  
Louis Messina ◽  
Phong Dargon ◽  
Wei Huang ◽  
Rocco Ciocca ◽  
...  
Keyword(s):  
United States ◽  
Pulmonary Embolism ◽  
Clinical Outcomes ◽  
Resource Utilization ◽  
The United States ◽  
Recent Trends

Disparities in access to surgery for glioblastoma multiforme at high-volume Commission on Cancer–accredited hospitals in the United States

2021 ◽  
pp. 1-10
Author(s):  
Anshit Goyal ◽  
Jad Zreik ◽  
Desmond A. Brown ◽  
Panagiotis Kerezoudis ◽  
Elizabeth B. Habermann ◽  
...  
Keyword(s):  
United States ◽  
Surgical Intervention ◽  
Residential Location ◽  
High Volume ◽  
The United States ◽  
National Cancer Database ◽  
Subgroup Analyses ◽  
Access To Surgery ◽  
Hispanic White ◽  
White Patients

OBJECTIVE Although it has been shown that surgery for glioblastoma (GBM) at high-volume facilities (HVFs) may be associated with better postoperative outcomes, the use of such hospitals may not be equally distributed. The authors aimed to evaluate racial and socioeconomic differences in access to surgery for GBM at high-volume Commission on Cancer (CoC)–accredited hospitals. METHODS The National Cancer Database was queried for patients with GBM that was newly diagnosed between 2004 and 2015. Patients who received no surgical intervention or those who received surgical intervention at a site other than the reporting facility were excluded. Annual surgical case volume was calculated for each hospital, with volume ≥ 90th percentile defined as an HVF. Multivariable logistic regression was performed to identify patient-level predictors for undergoing surgery at an HVF. Furthermore, multiple subgroup analyses were performed to determine the adjusted odds ratio of the likelihood of undergoing surgery at an HVF in 2016 as compared to 2004 for each patient subpopulation (by age, race, sex, educational group, etc.). RESULTS A total of 51,859 patients were included, with 10.7% (n = 5562) undergoing surgery at an HVF. On multivariable analysis, Hispanic White patients (OR 0.58, 95% CI 0.49–0.69, p < 0.001) were found to have significantly lower odds of undergoing surgery at an HVF (reference = non-Hispanic White). In addition, patients from a rural residential location (OR 0.55, 95% CI 0.41–0.72, p < 0.001; reference = metropolitan); patients with nonprivate insurance status (Medicare [OR 0.78, 95% CI 0.71–0.86, p < 0.001], Medicaid [OR 0.68, 95% CI 0.60–0.78, p < 0001], other government insurance [OR 0.68, 95% CI 0.52–0.86, p = 0.002], or who were uninsured [OR 0.61, 95% CI 0.51–0.72, p < 0.001]); and lower-income patients ($50,354–$63,332 [OR 0.68, 95% CI 0.63–0.74, p < 0.001], $40,227–$50,353 [OR 0.84, 95% CI 0.76–0.92, p < 0.001]; reference = ≥ $63,333) were also found to be significantly associated with a lower likelihood of surgery at an HVF. Subgroup analyses revealed that elderly patients (age ≥ 65 years), both male and female patients and non-Hispanic White patients, and those with private insurance, Medicare, metropolitan residential location, median zip code–level household income in the first and second quartiles, and educational attainment in the first and third quartiles had increased odds of undergoing surgery at an HVF in 2016 compared to 2004 (all p ≤ 0.05). On the other hand, patients with other governmental insurance, patients with a rural residence, and those from a non-White racial category did not show a significant difference in odds of surgery at an HVF over time (all p > 0.05). CONCLUSIONS The present analysis from the National Cancer Database revealed significant disparities in access to surgery at an HVF for GBM within the United States. Furthermore, there was evidence that these racial and socioeconomic disparities may have widened between 2004 and 2016. The findings should assist health policy makers in the development of strategies for improving access to HVFs for racially and socioeconomically disadvantaged populations.

Maternal Mortality in the United States: Recent Trends, Current Status, and Future Considerations

2021 ◽  
Vol 41 (3) ◽  
pp. 110-110
Author(s):  
K.S. Joseph ◽  
A. Boutin ◽  
S. Lisonkova ◽  
G.M. Muraca ◽  
N. Razaz ◽  
...  
Keyword(s):  
United States ◽  
Maternal Mortality ◽  
The United States ◽  
Current Status ◽  
Recent Trends
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