Comparison of the progression-free survival between robot-assisted thymectomy and video-assisted thymectomy for thymic epithelial tumors: a propensity score matching study

ObjectiveThe association between the prognosis of thymoma and MG remains controversial. Differences in clinical characteristics and treatments between patients with and without MG may affect the findings of those studies. We designed this propensity score matching trial to investigate whether MG is an independent prognostic predictor in thymoma.MethodsPatients with pathologically diagnosed thymoma and MG were enrolled in the MG group. Moreover, the propensity score matching method was used to select patients who were diagnosed with thymoma without MG from the database of two participating centers. Matched factors included sex, age, Masaoka stage, pathological subtypes, and treatments. Matched patients were enrolled in the non-MG group. Chi-squared test was used to compare the characteristics of the two groups. Overall survival, local-regional relapse-free survival, distant metastasis-free survival, progression-free survival, and cancer-specific survival were calculated from the diagnosis of thymoma using the Kaplan–Meier method.ResultsBetween April 1992 and October 2018, 235 patients each were enrolled in the MG and non-MG groups (1:1 ratio). The median ages of patients in the MG and non-MG groups were 46 years old. The World Health Organization pathological subtypes were well balanced between the two groups (B2 + B3: MG vs. non-MG group, 63.0 vs. 63.4%, p = 0.924). Most patients in both groups had Masaoka stages I–III (MG vs. non-MG group, 90.2 vs. 91.5%, p = 0.631). R0 resections were performed in 86.8 and 90.2% of the MG and non-MG groups, respectively (p = 0.247). The median follow-up time of the two groups was 70.00 months (MG vs. non-MG group, 73.63 months vs. 68.00 months). Five-year overall survivals were 92.5 and 90.3%, 8-year overall survivals were 84.2 and 84.2%, and 10-year overall survivals were 80.2 and 81.4% (p = 0.632) in the MG and non-MG groups, respectively. No differences were found in the progression-free survival, distant metastasis-free survival, and local-regional relapse-free survival between the two groups.ConclusionMG is not an independent or direct prognostic factor of thymoma, although it might be helpful in diagnosis thymoma at an early stage, leading indirectly to better prognosis.

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Neoadjuvant Chemotherapy Followed by Radiofrequency Ablation Prolongs Survival for Ablatable Colorectal Liver Metastasis: A Propensity Score Matching Comparative Study

Frontiers in Oncology ◽

10.3389/fonc.2021.758552 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yizhen Chen ◽

Youyao Xu ◽

Linwei Xu ◽

Fang Han ◽

Yurun Huang ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Liver Metastasis ◽

Neoadjuvant Chemotherapy ◽

Propensity Score ◽

Tumor Progression ◽

Propensity Score Matching ◽

Progression Free Survival ◽

Local Tumor Progression ◽

Local Tumor ◽

Free Survival

BackgroundTypically, colorectal liver metastasis (CRLM) is not a candidate for hepatectomy. Radiofrequency ablation (RFA) plays a critical role in unresectable CRLM patients. Nevertheless, high local tumor progression (LTP) and distant metastasis limit the development and further adoption and use of RFA. Neoadjuvant chemotherapy (NAC) has been widely used in resectable CRLM and is recommended by the guidelines. There are no studies on whether NAC can improve the prognosis in ablatable CRLM patients. The present study aimed to determine the feasibility and effectiveness of RFA plus NAC.MethodsThis retrospective cohort included CRLM patients from Zhejiang Cancer Hospital records, who received RFA from January 2009 to June 2020 and were divided into two groups according to the presence or absence of NAC. The Kaplan–Meier method was used to evaluate the 3-year local tumor progression-free survival (LTPFS), progression-free survival (PFS), and overall survival (OS) of the two groups. The propensity score matching was used to reduce bias when assessing survival. Multivariate Cox proportional hazards regression analysis was used to study the independent factors affecting LTPFS, PFS, and OS.ResultsA total of 149 CRLM patients (88 in the RFA alone group and 61 in the plus NAC group) fulfilled the inclusion criteria. Post-RFA complications were 3.4% in the RFA alone group and 16.4% in the plus NAC group. The 3-year LTPFS, PFS, and OS of the RFA only group were 60.9%, 17.7%, and 46.2%, respectively. The 3-year LTPF, PFS, and OS of the plus NAC group were 84.9%, 46.0%, and 73.6%, respectively. In the 29 pairs of propensity score matching cohorts, the 3-year LTPFS, PFS, and OS in the plus NAC group were longer than those in the RFA group (P < 0.05). NAC was an independent protective factor for LTPFS, PFS, and OS (P < 0.05).ConclusionsFor ablatable CRLM patients, RFA plus NAC obtained a better prognosis than RFA alone. Based on the current results, the application of NAC before RFA may become the standard treatment.

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Local treatment combined with chemotherapy improves survival of patients with pulmonary metastases of colorectal cancer—a real-world retrospective study

10.21203/rs.3.rs-27518/v1 ◽

2020 ◽

Author(s):

Zikai Cai ◽

Qingbing Wang ◽

Xiaofeng Yang ◽

Xiaolong Ye ◽

Jiafeng Fang ◽

...

Keyword(s):

Colorectal Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Pulmonary Metastases ◽

Lung Metastases ◽

Local Treatment ◽

Multivariable Analysis ◽

Progression Free Survival ◽

Cox Proportional Hazards ◽

Free Survival

Abstract Background The effect of local treatments for pulmonary metastases from colorectal cancer (CRC-PM) remains controversial. This study aims to figure out whether local treatments combined with chemotherapy could improve patients’ survival by comparing the outcomes of CRC-PM patients who submitted to local interventions combined with chemotherapy or just chemotherapy.Patients and Methods From January 2009 to July 2019, a total of 119 patients with CRC-PM from two surgical centers were reviewed. Patients were divided into two groups according to treatments for the lung metastases: Local intervention combined with chemotherapy (Group-LI) and Chemotherapy alone (Group-Chem). Overall survival (OS) and progression-free survival (PFS) were assessed with the Kaplan-Meier method. Clinical characteristics associated with prognosis were analyzed by using a Cox proportional hazards regression model. Propensity score matching analyses were used to overcome the possible biases in some baseline characteristics.Result Multivariable analysis revealed that the level of carcinoembryonic antigen (CEA) and treatment for CRC-PM are independent predictors of both OS and PFS. The median OS in Group-LI (n = 39) and Group-Chem (n = 80) were 34.5 months and 13.8 months, respectively(P < 0.001). The 3-year progression-free survival rate in Group-LI and Group-Chem were 75.2% and 45.1% (P < 0.001). After propensity score matching, patients in Group-LI had better OS (HR = 3.304, P = 0.022) and PFS (HR = 4.029, P < 0.001) than Group-Chem.Conclusion. CRC-PM patients with lower lever of CEA or local treatment of lung metastases are more likely to be those with favorable prognosis. Selected CRC-PM patients could benefit from local treatment of pulmonary metastases.

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AB015. OS04.01. Robotic thymectomy in thymic epithelial tumors: a propensity score matching study of 112 consecutive cases

Mediastinum ◽

10.21037/med.2017.ab015 ◽

2017 ◽

Vol 1 ◽

pp. AB015-AB015

Author(s):

Samina Park ◽

Kwan Yong Hyun ◽

Hyun Joo Lee ◽

In Kyu Park ◽

Young Tae Kim ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Thymic Epithelial Tumors ◽

Epithelial Tumors ◽

Robotic Thymectomy

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Second-Line Intraperitoneal Chemotherapy for Recurrent Epithelial Ovarian, Tubal and Peritoneal Cancer: A Propensity Score-Matching Study

Chemotherapy ◽

10.1159/000443924 ◽

2016 ◽

Vol 61 (5) ◽

pp. 240-248 ◽

Cited By ~ 2

Author(s):

Chien-Hsing Lu ◽

Yen-Hou Chang ◽

Wai-Hou Lee ◽

Yi Chang ◽

Chia-Wen Peng ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Large Scale ◽

Progression Free Survival ◽

Second Line ◽

Free Survival ◽

Peritoneal Cancer ◽

Platinum Sensitive ◽

Resistant Disease ◽

Platinum Refractory

Background: The superiority of frontline intraperitoneal (IP) over intravenous (IV) chemotherapy is well established in the treatment of epithelial ovarian cancer. However, the role of IP chemotherapy in the second-line setting has rarely been investigated. Methods: Consecutive patients diagnosed with recurrent epithelial, tubal and peritoneal cancers between January 2000 and December 2012 were recruited using a propensity score-matching technique to adjust relevant risk factors. Results: In total, 310 patients were included in the final analysis (94 for platinum-refractory/resistant disease and 216 for platinum-sensitive disease). IP chemotherapy demonstrated significantly longer median progression-free survival than IV chemotherapy (4.9 vs. 2.4 months, p < 0.001, for platinum-refractory/resistant disease, and 9.8 vs. 6.9 months, p < 0.001, for platinum-sensitive disease). Conclusions: Second-line IP chemotherapy confers longer progression-free survival than IV chemotherapy. Large-scale clinical trials should be conducted to validate the true efficacy.

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Postoperative radiation for tumor control and overall survival in thymic epithelial tumors (TET): A matched-pair analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.8572 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 8572-8572

Author(s):

Feng Ming Kong ◽

Yong Zang ◽

Weili Wang ◽

Hong Zhang ◽

Jessica Smith ◽

...

Keyword(s):

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Cox Model ◽

Matched Pair ◽

Tumor Control ◽

Postoperative Radiation ◽

Single Institution ◽

Thymic Epithelial Tumors ◽

Epithelial Tumors

8572 Background: Due to lack of randomized trials, the role of postoperative radiation therapy (PORT) in thymic epithelial tumors (TET) remains controversial. This study aimed to evaluate whether PORT improves tumor control and overall survival (OS) in patients with resected TET in a large single institution database. Methods: This is a retrospective study of all TETs seen at Indiana University between 1975 and 2016. Patients with resected thymoma (T) or thymic carcinoma (TC) were eligible disregarding their margin status or stage. Study endpoints were progression free survival (PFS) and OS. Age, gender, race, tumor size, stage, pathology, grade, completeness of resection and adjuvant treatment modality were analyzed for significance on PFS and OS. Multivariate Cox model was used to identify significant factors for propensity score matching. Differences between the PORT and surgery alone group were estimated using stratified log-rank test. Results: A total of 478 patients with previous surgical resection were eligible. Masaoka Stage was: I-86 (22%); II-87 (23%); III-107 (28%); and IV-106 (27%), respectively. Multivariate analysis demonstrated that gender (HR = 1.4, p = 0.03), stage (HR = 1.3, p = 3×10-3), TC (HR = 1.6, p = 0.03) and PORT (HR = 1.6, p = 0.002) were significantly associated with PFS. Age (HR = 1.1, p = 4×10-7), TC (HR = 3.2, p = 3×10-5), stage (HR = 1.4, p = 0.003) were associated with OS. PORT was given to 126 (26%) patients. Propensity score matching based on independent prognostic factors identified 99 patients for PORT, matched to 285 patients without. The 5-/10-year intra-thoracic progression free rates were 77%/69% and 85%/68%, for patients with and without PORT (p = 0.009), respectively. The 5-/10-year PFS rates were 39%/18% and 61%/32%, for patients with and without PORT (p = 0.002), respectively. The median survival, 5-/10-year OS rates for patients treated with PORT were 150 (95%CI 111~277) months, 87%/57% and respectively, compared to 192 months (95%CI 167~279), 88%/69% for patients receiving surgery alone ( p = 0.13). Conclusions: This matched-paired analysis from a single institution suggests that PORT does not impact the PFS or OS in a selected population of resected TET.

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Analysis of data collected in the European Society for Blood and Marrow Transplantation (EBMT) Registry on a cohort of lymphoma patients receiving plerixafor

Bone Marrow Transplantation ◽

10.1038/s41409-019-0693-z ◽

2019 ◽

Vol 55 (3) ◽

pp. 613-622 ◽

Cited By ~ 3

Author(s):

Anna Sureda ◽

Christian Chabannon ◽

Tamás Masszi ◽

David Pohlreich ◽

Christof Scheid ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Progression Free Survival ◽

Hematopoietic Stem ◽

Free Survival ◽

Blood And Marrow Transplantation ◽

Comparison Groups ◽

Long Term Follow Up

Abstract Plerixafor + granulocyte-colony stimulating factor (G-CSF) is administered to patients with lymphoma who are poor mobilizers of hematopoietic stem cells (HSCs) in Europe. This international, multicenter, non-interventional registry study (NCT01362972) evaluated long-term follow-up of patients with lymphoma who received plerixafor for HSC mobilization versus other mobilization methods. Propensity score matching was conducted to balance baseline characteristics between comparison groups. The following mobilization regimens were compared: G-CSF + plerixafor (G + P) versus G-CSF alone; G + P versus G-CSF + chemotherapy (G + C); and G-CSF + plerixafor + chemotherapy (G + P + C) versus G + C. The primary outcomes were progression-free survival (PFS), overall survival (OS), and cumulative incidence of relapse (CIR). Overall, 313/3749 (8.3%) eligible patients were mobilized with plerixafor-containing regimens. After propensity score matching, 70 versus 36 patients were matched in the G + P versus G-CSF alone cohort, 124 versus 124 in the G + P versus G + C cohort, and 130 versus 130 in the G + P + C versus G + C cohort. For both PFS and OS, the upper bound of confidence interval for the hazard ratio was >1.3 for all comparisons, implying that non-inferiority was not demonstrated. No major differences in PFS, OS, and CIR were observed between the plerixafor and comparison groups.

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Video-assisted thoracoscopic thymectomy is feasible for large thymomas: a propensity-matched comparison

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivz320 ◽

2020 ◽

Vol 30 (4) ◽

pp. 565-572

Author(s):

Wenhan Weng ◽

Xiao Li ◽

Shushi Meng ◽

Xianping Liu ◽

Peng Peng ◽

...

Keyword(s):

Overall Survival ◽

Propensity Score ◽

Propensity Score Matching ◽

Recurrence Free Survival ◽

Free Survival ◽

Propensity Score Matching Analysis ◽

Video Assisted ◽

Significant Difference ◽

Group A ◽

Group B

Abstract OBJECTIVES Video-assisted thoracoscopic thymectomy is becoming the preferable approach for early-stage thymoma. However, large thymomas are still recognized as a relative contraindication due to the possible risk of incomplete resection or capsular disruption. Thus, the aim of this study is to evaluate the feasibility of video-assisted thoracoscopic thymectomy for large thymomas. METHODS Patients diagnosed with Masaoka stage I–IV thymoma between April 2001 and December 2018 were retrospectively reviewed. All patients were divided into 2 groups: thymoma <5.0 cm (group A) and thymoma ≥5.0 cm (group B). Propensity score matching analysis was performed to compare postoperative results. Recurrence-free survival and overall survival were compared for oncological evaluation. RESULTS A total of 346 patients were included in this study. In the propensity score matching analysis, 126 patients were included both in group A and group B. There was no significant difference between these 2 groups in terms of the R0 resection rate (95.2% vs 94.4%, P = 1.000), conversion rate (1.6% vs 3.2%, P = 0.684), operation time (119.4 ± 48.4 vs 139.1 ± 46.6 min, P = 0.955), blood loss (93.2 ± 231.7 vs 100.5 ± 149.3 ml, P = 0.649), duration of chest drainage (2.7 ± 1.6 vs 2.8 ± 2.0 days, P = 0.184), length of hospitalization (5.0 ± 3.9 vs 5.2 ± 2.9 days, P = 0.628) or postoperative complications (5.9% vs 8.5%, P = 0.068). There was no significant difference between these 2 groups in terms of the overall survival (P = 0.271) and recurrence-free survival (P = 0.288). CONCLUSIONS Video-assisted thoracoscopic thymectomy is a safe and effective approach for large thymomas (≥5 cm) with comparable surgical and oncological results.

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Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa246 ◽

2021 ◽

Author(s):

Zhen Yang ◽

Hengjun Gao ◽

Jun Lu ◽

Zheyu Niu ◽

Huaqiang Zhu ◽

...

Keyword(s):

Overall Survival ◽

Postoperative Complications ◽

Propensity Score ◽

Propensity Score Matching ◽

Neuroendocrine Tumors ◽

Disease Free Survival ◽

Pancreatic Neuroendocrine Tumors ◽

Free Survival ◽

Estimated Blood Loss ◽

Disease Free

Abstract Objective There are limited data from retrospective studies on whether therapeutic outcomes after regular pancreatectomy are superior to those after enucleation in patients with small, peripheral and well-differentiated non-functional pancreatic neuroendocrine tumors. This study aimed to compare the short- and long-term outcomes of regular pancreatectomy and enucleation in patients with non-functional pancreatic neuroendocrine tumors. Methods Between January 2007 and July 2020, 227 patients with non-functional pancreatic neuroendocrine tumors who underwent either enucleation (n = 89) or regular pancreatectomy (n = 138) were included. Perioperative complications, disease-free survival, and overall survival probabilities were compared. Propensity score matching was performed to balance the baseline differences between the two groups. Results The median follow-up period was 60.76 months in the enucleation group and 43.29 months in the regular pancreatectomy group. In total, 34 paired patients were identified after propensity score matching. The average operative duration in the enucleation group was significantly shorter than that in the regular pancreatectomy group (147.94 ± 42.39 min versus 217.94 ± 74.60 min, P < 0.001), and the estimated blood loss was also significantly lesser (P < 0.001). The matched patients who underwent enucleation displayed a similar overall incidence of postoperative complications (P = 0.765), and a comparable length of hospital stay (11.12 ± 3.90 days versus 9.94 ± 2.62 days, P = 0.084) compared with those who underwent regular pancreatectomy. There were no statistically significant differences between the two groups in disease-free survival and overall survival after propensity score matching. Conclusion Enucleation in patients with non-functional pancreatic neuroendocrine tumors was associated with shorter operative time, lesser intraoperative bleeding, similar overall morbidity of postoperative complications, and comparable 5-year disease-free survival and overall survival when compared with regular pancreatectomy.

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Postoperative non-steroidal anti-inflammatory drug use and oncological outcomes of rectal cancer

BJS Open ◽

10.1093/bjsopen/zraa050 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

O Grahn ◽

M Lundin ◽

M-L Lydrup ◽

E Angenete ◽

M Rutegård

Keyword(s):

Rectal Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Instrumental Variables ◽

Cox Regression ◽

Recurrence Free Survival ◽

Free Survival ◽

Oncological Outcomes ◽

Anti Inflammatory ◽

Instrumental Variables Approach

Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs) are known to suppress the inflammatory response after surgery and are often used for pain control. This study aimed to investigate NSAID use after radical surgical resection for rectal cancer and long-term oncological outcomes. Methods A cohort of patients who underwent anterior resection for rectal cancer between 2007 and 2013 in 15 hospitals in Sweden was investigated retrospectively. Data were obtained from the Swedish Colorectal Cancer Registry and medical records; follow-up was undertaken until July 2019. Patients who received NSAID treatment for at least 2 days after surgery were compared with controls who did not, and the primary outcome was recurrence-free survival. Cox regression modelling with confounder adjustment, propensity score matching, and an instrumental variables approach were used; missing data were handled by multiple imputation. Results The cohort included 1341 patients, 362 (27.0 per cent) of whom received NSAIDs after operation. In analyses using conventional regression and propensity score matching, there was no significant association between postoperative NSAID use and recurrence-free survival (adjusted hazard ratio (HR) 1.02, 0.79 to 1.33). The instrumental variables approach, including individual hospital as the instrumental variable and clinicopathological variables as co-variables, suggested a potential improvement in the NSAID group (HR 0.61, 0.38 to 0.99). Conclusion Conventional modelling did not demonstrate an association between postoperative NSAID use and recurrence-free survival in patients with rectal cancer, although an instrumental variables approach suggested a potential benefit.

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