Upfront surgery, neoadjuvant, and definitive chemoradiation for clinical T2N0 esophageal adenocarcinoma: A propensity score matched analysis from the National Cancer Database analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 103-103
Author(s):  
Ravi Shridhar ◽  
Jamie Huston ◽  
Kenneth L Meredith
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Esophageal Adenocarcinoma ◽  
Neoadjuvant Chemoradiation ◽  
Clinical Staging ◽  
National Cancer Database ◽  
High Grade ◽  
Database Analysis ◽  
Tumor Length ◽  
Definitive Chemoradiation

103 Background: To compare overall survival (OS) of T2N0 esophageal adenocarcinomas treated with either upfront surgery (US), neoadjuvant chemoradiation (NCR), or definitive chemoradiation (DCR) from the National Cancer Database (NCDB). Methods: The NCDB was accessed to identify patients with T2N0 esophageal adenocarcinoma treated between 2004-2013 with either US, NCR, or DCR. NCR and DCR patients were included if they were treated with a radiation dose between 45-50.4 Gy and received chemotherapy. Propensity score matching (PSM) was performed against age and tumor length. Results: After PSM, 446 patients (US 98; NCR 203; DCR 145) were included in the analysis. There was no difference in age, tumor length, and grade. Clinical staging in US patients was accurate pathologically in 32.6% of patients. Median and 5 year OS for US, NCR, and DCR patients was 42.5 months and 40%, 48.5 months and 48%, and 22.9 months and 20%, respectively (p<0.001). There was no difference in OS based on response to NCR compared to US. NCR was associated with improved OS in patients with tumors >3 cm compared to US (median OS 43.8 versus 36.4 months; p=0.01). There was a trend toward improved OS with NCR in high grade tumors compared to US. UVA and MVA of OS revealed that DCR was associated with worse survival. Conclusions: Clinical staging for T2N0 esophageal adenocarcinoma continues to remain highly inaccurate. There was no difference in OS between US and NCR, however, improved OS was seen in NCR patients with tumors >3 cm.

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.

A National Cancer Database analysis of the patterns of care for meningeal melanocytoma

2021 ◽  
Author(s):  
Amanda C Tep ◽  
Patrick D Kelly ◽  
Daphne B Scarpelli ◽  
Bailey Bergue ◽  
Shearwood McClelland III ◽  
...  
Keyword(s):  
Overall Survival ◽  
Patient Outcomes ◽  
Cox Regression ◽  
Treatment Patterns ◽  
National Cancer Database ◽  
Regression Analyses ◽  
Database Analysis ◽  
Meningeal Melanocytoma ◽  
Kaplan Meier ◽  
Poor Treatment

Aim: To evaluate demographics, treatment patterns, radiotherapy utilization and patient outcomes in meningeal melanocytomas. Materials & methods: The National Cancer Database was queried for meningeal melanocytomas diagnosed in 2002–2016. The effects of demographic, clinical and treatment variables were determined via Kaplan–Meier log-rank and Cox regression analyses. Results: The median and 5-year overall survival were 57.46 months and 48%, respectively. Patients earning ≥ $48K showed improved survival (p = 0.0319). Radiotherapy and chemotherapy were utilized in 37.7 and 9% of patients, respectively. Conclusion: Income significantly affected survival. Surgery remains the mainstay approach. Radiotherapy was delivered in more than one-third of patients but did not impact survival. However, further analyses were limited by poor treatment modality information in the database.

Determinants of ten-year overall survival of acute myeloid leukemia: a large national cancer database analysis

2021 ◽  
pp. 1-7
Author(s):  
Nabin Khanal ◽  
Valerie Shostrom ◽  
Prajwal Dhakal ◽  
Shristi Upadhyay Banskota ◽  
Chakra Chaulagain ◽  
...  
Keyword(s):  
Overall Survival ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
National Cancer Database ◽  
Database Analysis ◽  
Acute Myeloid

Commission on Cancer CP3R Compliance Rates for Treatment of Patients With Triple Negative and HER2+ Breast Cancer: A National Cancer Database Analysis

2021 ◽  
pp. 000313482110516
Author(s):  
Srivarshini C. Mohan ◽  
Joshua Tseng ◽  
Marissa Srour ◽  
Alice Chung ◽  
Ashley Marumoto ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Quality Care ◽  
Private Insurance ◽  
National Cancer Database ◽  
Database Analysis ◽  
Her2 Breast Cancer ◽  
Academic Hospitals ◽  
Multi Agent

Background Cancer Program Practice Profile Reports (CP3R) metrics were released by the Commission on Cancer to provide standards for high-quality care. One metric is the recommendation of combination chemotherapy or chemo-immunotherapy (CIT) within 120 days of diagnosis for women under 70 with AJCC T1cN0M0 or Stage IB-III HER2+ or hormone receptor negative breast cancer ([Multi-agent chemotherapy] MAC). Our study assesses national concordance rates for MAC and CIT. Methods The National Cancer Database was queried from 2004-2014. Results 122,045 patients met criteria, of whom treatment for 101,800 (83.4%) patients was concordant with MAC and CIT. Treatment concordance increased from 75.7% in 2004 to 89.5% in 2014. For HER2+ patients, use of CIT treatment downtrended with progression of pathological stage, from 70.1% (stage I) to 58.1% (stage III). Mean overall survival of patients whose treatment was concordant with MAC and CIT was longer than that of patients who were non-concordant (146.6 vs 143.8 months, P <.01). On Cox regression, there was a survival benefit for concordant patients who were treated at academic hospitals (HR .89, 95% CI 0.802-.976) and had private insurance (HR .76, 95% CI 0.65-.89). Conclusion Compliance with MAC and CIT has improved over the past decade and is associated with a significant improvement in overall survival.

scholarly journals Novel Calculator to Estimate Overall Survival Benefit from Neoadjuvant Chemoradiation in Patients with Esophageal Adenocarcinoma

2017 ◽  
Vol 224 (5) ◽  
pp. 884-894.e1 ◽  
Author(s):  
Emmanuel Gabriel ◽  
Kristopher Attwood ◽  
Rupen Shah ◽  
Steven Nurkin ◽  
Steven Hochwald ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Adenocarcinoma ◽  
Survival Benefit ◽  
Neoadjuvant Chemoradiation ◽  
Overall Survival Benefit
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