scholarly journals Survival of patients with appendiceal neuroendocrine tumors: whether they benefit from right hemicolectomy?

2020 ◽  
Author(s):  
Haiping Lin ◽  
Liyuan Wang ◽  
Yang Bai ◽  
Chenyang Ge ◽  
Hongjuan Zheng ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Right Hemicolectomy ◽  
Prognostic Impact ◽  
Subdistribution Hazard ◽  
Survival Difference

Abstract Background: Current guidelines recommend right hemicolectomy for appendiceal neuroendocrine tumors (A-NETs) patients with lymph node (LN) metastasis. However, prognosis of these patients is favorable, and the prognostic impact of metastatic LN is controversial.Objective: The study aims to evaluate the prognostic factors of A-NETs, and explore whether right hemicolectomy/ more extended procedure (RHCM) improves prognosis compared to less extended than right hemicolectomy (LRHC).Methods: Patients with A-NETs were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The Fine-Gray proportional hazards model was established to calculate subdistribution hazard ratios of prognostic factors. A propensity score matching was performed to balance intergroup differences between the LRHC and RHCM groups, and survival difference between the after-matched groups was tested using the Gray test. Subgroup analyses were also conducted.Results: In the multivariate analysis, histological type and distant metastatic status were associated with prognosis, while tumor size and nodal status were not. After propensity score matching, the patients’ characteristics were well balanced. RHCM did not confer survival benefits in the whole after-matched patients or any subgroup.Conclusions: Metastatic LN does not significantly impact prognosis, and RHCM fails to improve prognosis compared to LRHC. Therefore, the current “LN-decided” surgical procedure may not be suitable for patients with A-NETs.

Impact of metastatic lymph nodes on survival in well and moderately differentiated appendiceal neuroendocrine tumors: whether current “lymph node-decided” surgical strategy benefits?

2020 ◽  
Author(s):  
Haiping Lin ◽  
Liyuan Wang ◽  
Yang Bai ◽  
Shian Yu
Keyword(s):  
Prognostic Factors ◽  
Lymph Node ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Right Hemicolectomy ◽  
Prognostic Impact ◽  
Survival Difference

Abstract Background Current guidelines recommended right hemicolectomy for appendiceal neuroendocrine tumors (A-NETs) patients with lymph node (LN) metastasis. Prognoses of these patients are favorable, and the prognostic impact of metastatic LN is controversial.Objective The study aims to evaluate the prognostic factors of well and moderately differentiated A-NETs, and explore whether right hemicolectomy/ more extended procedure (RHCM) improves prognosis compared to less extended than right hemicolectomy (LRHC).Methods The Fine-Gray proportional hazards model was established to calculate subdistribution hazard ratios of prognostic factors. A propensity score matching was performed to balance intergroup differences between the LRHC and RHCM groups. Survival difference between the after-matched groups was tested using the Gray test, and subgroup analyses were conducted.Results In the multivariate analysis, age, race, histological type and distant metastatic status were associated with prognosis, while tumor size and nodal status were not. After propensity score matching, the patients’ characteristics were well balanced. RHCM did not confer survival advantage in the whole after-matched patients or any subgroup.Conclusions Metastatic LN does not significantly impact prognosis, and RHCM fails to improve prognosis compared to LRHC. Therefore, the current “LN-decided” surgical procedure may not be suitable for patients with well and moderately differentiated A-NETs.

scholarly journals Urban–Rural Disparities in the Incidence of Diabetes-Related Complications in Taiwan: A Propensity Score Matching Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 3012
Author(s):  
Shu-Yu Tai ◽  
Jiun-Shiuan He ◽  
Chun-Tung Kuo ◽  
Ichiro Kawachi
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Rural Areas ◽  
Urban Areas ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Propensity Score Matching Analysis ◽  
Urban Rural

Although a disparity has been noted in the prevalence and outcome of chronic disease between rural and urban areas, studies about diabetes-related complications are lacking. The purpose of this study was to examine the association between urbanization and occurrence of diabetes-related complications using Taiwan’s nationwide diabetic mellitus database. In total, 380,474 patients with newly diagnosed type 2 diabetes between 2000 and 2008 were included and followed up until 2013 or death; after propensity score matching, 31,310 pairs were included for analysis. Occurrences of seven diabetes-related complications of interest were identified. Cox proportional hazards model was used to determine the time-to-event hazard ratio (HR) among urban, suburban and rural groups. We found that the HRs of all cardiovascular events during the five-year follow-up was 1.04 times (95% confidence interval (CI) 1.00–1.07) and 1.15 times (95% CI 1.12–1.19) higher in suburban and rural areas than in urban areas. Patients in suburban and rural areas had a greater likelihood of congestive heart failure, stroke, and end-stage renal disease than those in urban areas. Moreover, patients in rural areas had a higher likelihood of ischemic heart disease, blindness, and ulcer than those in urban areas. Our empirical findings provide evidence for potential urban–rural disparities in diabetes-related complications in Taiwan.

scholarly journals Albumin-To-Alkaline Phosphatase Ratio as a Novel and Promising Prognostic Biomarker in Patients Undergoing Esophagectomy for Carcinoma: A Propensity Score Matching Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Xianying Zhu ◽  
Dongni Chen ◽  
Shuangjiang Li ◽  
Wenbiao Zhang ◽  
Yongjiang Li ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Prognostic Factors ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Proportional Hazards ◽  
Predictive Accuracy ◽  
Progression Free Survival ◽  
Cox Proportional Hazards ◽  
Prognostic Effect ◽  
Significant Difference

BackgroundAlbumin-to-alkaline phosphatase ratio (AAPR) has been reported as a novel prognostic predictor for numerous solid tumors. We aimed to assess the prognostic role of preoperative AAPR in surgically resectable esophageal squamous cell carcinoma (ESCC) by a propensity score matching (PSM) analysis with predictive nomograms.MethodsOur study was conducted in a single-center prospective database between June 2009 and December 2012. Kaplan-Meier analysis was used to distinguish the difference in survival outcomes between patients stratified by an AAPR threshold. Multivariable Cox proportional hazards regression model was finally generated to specify independent prognostic markers for the entire and PSM cohorts.ResultsA total of 497 patients with ESCC were included in this study. An AAPR of 0.50 was determined as the optimal cutoff point for prognostic outcome stratification. Patients with AAPR<0.50 had significantly worse overall survival (OS), and progression-free survival (PFS) compared to those with AAPR≥0.50 (Log-rank P<0.001). This significant difference remained stable in the PSM analysis. Multivariable analyses based on the entire and PSM cohorts consistently showed that AAPR<0.50 might be one of the most predominant prognostic factors resulting in unfavorable OS and PFS of ESCC patients undergoing esophagectomy (P<0.001). The nomograms consisting of AAPR and other independent prognostic factors further demonstrated a plausible predictive accuracy of postoperative OS and PFS.ConclusionAAPR can be considered as a simple, convenient and noninvasive biomarker with a significant prognostic effect in surgically resected ESCC.

Prognostic Impact of Lymphadenectomy in Different Stages of Malignant Germ Cell Tumor of the Ovary Based on Propensity Score Matching

2019 ◽  
Vol 21 (9) ◽  
pp. 652-661 ◽  
Author(s):  
Ying Chen ◽  
Yang Ning ◽  
Qinghua Zhang ◽  
Ying Xie
Keyword(s):  
Lymph Node ◽  
Propensity Score ◽  
Germ Cell ◽  
Propensity Score Matching ◽  
Germ Cell Tumor ◽  
Cell Tumor ◽  
Stage I ◽  
Prognostic Impact ◽  
Lymph Node Resection ◽  
Malignant Germ Cell Tumor

Background: Lymphadenectomy has been widely used in the treatment of malignant germ cell tumor of the ovary (OGCT), which is a kind of ovarian cancers occurred mostly in young women and adolescent girls. But the clinical decision mainly depends on the doctor’s experience without a well-defined guideline. This population-based study aimed to evaluate the prognostic impact of lymphadenectomy in different stages of malignant germ cell tumors of the ovary. Methods: Patients with known status of lymphadenectomy in different stages of OGCT were explored from the Surveillance, Epidemiology, and End Results (SEER) program database from 1973 to 2013. We used propensity score matching algorithm to reduce the selection bias between the two study groups. Survival curves, univariate and multivariate Cox proportional hazards model were applied to evaluate the prognostic impact of lymphadenectomy in different stages of OGCT. Results: We included 1,996 OGCT patients in the study, and 818 (41%) of them had lymph node resection. Compared to the LND- group, patients with lymph node resection tended to be at stage II and III, had larger tumor sizes and diagnosed as dysgerminoma. The influence of diagnosis ages, marital status and tumor grades were significantly decreased by applying the propensity score matching. Lymphadenectomy-positive (LND+) group demonstrated significantly worse survival than the lymphadenectomy-negative (LND-) group in later stages (stage III, overall, P=0.027, cancerspecific, P=0.006; stage IV, overall, P=0.034, cancer-specific, P=0.037). While, both the overall and cancer-specific survival showed no significant differences between LND+ and LND- in stage I (overall, P=0.411, cancer-specific, P=0.876) and stage II (overall, P=12, cancer-specific, P=0.061). Univariate (overall, HR=1.497, CI=1.010-2.217, P=0.044; cancer-specific, HR=1.524, CI=1.067- 2.404, P=0.050) and multivariate (overall, HR=1.580, CI=1.046-2.387, P=0.030; cancer-specific, HR=1.661, CI=1.027-2.686, P=0.039) Cox proportional model both verified the association between the lymph node resection and better survival in the whole cohort. Conclusion: Lymphadenectomy significantly increased the survival probability of OGCT patients in stage III and IV, but had no significant influence on early-stage patients (stage I and II), indicating lymphadenectomy should be performed in a stage-dependent manner in clinical utility.

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

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.

scholarly journals Role of Removed Lymph Nodes on the Prognosis of M0 Small-Bowel Neuroendocrine Tumors: a Propensity Score Matching Analysis from SEER Database

2021 ◽  
Author(s):  
Jie-bin Xie ◽  
Yue-shan Pang ◽  
Xun Li ◽  
Xiao-ting Wu
Keyword(s):  
Small Bowel ◽  
Propensity Score ◽  
Lymph Nodes ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Prognostic Value ◽  
Radical Resection ◽  
Clinicopathological Characteristics ◽  
Seer Database ◽  
Resection Group

Abstract Background Current studies on the number of removed lymph nodes (LNs) and their prognostic value in small-bowel neuroendocrine tumors (SBNETs) are limited. This study aimed to clarify the prognostic value of removed LNs for SBNETs. Methods SBNET patients without distant metastasis from 2004 to 2017 in the SEER database were included. The optimal cutoff values of examined LNs (ELNs) and negative LNs (NLNs) were calculated by the X-tile software. Propensity score matching (PSM) was done to match patients 1:1 on clinicopathological characteristics between the two groups. The Kaplan-Meier method with log-rank test and multivariable Cox proportional-hazards regression model were used to evaluate the prognostic effect of removed LNs. Results The cutoff values of 14 for ELNs and 9 for NLNs could well distinguish patients with different prognoses. After 1:1 PSM, the differences in clinicopathological characteristics between the two groups were significantly reduced (all P > 0.05). Removal of more than one LN significantly improved the prognosis of the patients (P < 0.001). The number of lymphatic metastasis in the sufficiently radical resection group (SRR, 3.74 ± 3.278, ELN > 14 and NLN > 9) was significantly more than that in the insufficiently radical resection group (ISRR, 2.72 ± 3.19, ELN < 14 or NLN < 9). The 10-year overall survival (OS) of the SRR was significantly better than that of the ISRR (HR = 1.65, P = 0.001, 95% CI: 1.24–2.19). Conclusion Both ELNs and NLNs can well predict the OS of patients. Systematic removal of more than 14 LNs and more than 9 NLNs can increase the OS of SBNET patients.

scholarly journals Comparison between male and female breast cancer survival using propensity score matching analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Serena Scomersi ◽  
Fabiola Giudici ◽  
Giuseppe Cacciatore ◽  
Pasquale Losurdo ◽  
Stefano Fracon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Survival ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Female Breast Cancer ◽  
Lymph Node Status ◽  
Propensity Score Matching Analysis

AbstractMale breast cancer (MBC) is a rare disease. The few studies on MBC reported conflicting data regarding survival outcomes compared to women. This study has two objectives: to describe the characteristics of a single-cohort of MBC and to compare overall survival (OS) and disease-free survival (DFS) between men and women using the propensity score matching (PSM) analysis. We considered MBC patients (n = 40) diagnosed between January 2004 and May 2019. Clinical, pathological, oncological and follow-up data were analyzed. Univariate analysis was performed to determine the prognostic factors on OS and DFS for MBC. We selected female patients with BC (n = 2678). To minimize the effect of the imbalance of the prognostic factors between the two cohorts, the PSM method (1:3 ratio) was applied and differences in survival between the two groups were assessed. The average age of MBC patients was 73 years. The 5-year OS and DFS rates were 76.7% and 72.2% respectively. The prognostic factors that significantly influenced OS and DFS were tumor size and lymph node status. After the PSM, 5 year-OS was similar between MBC and FBC (72.9% vs 72.3%, p = 0.70) while we found a worse DFS for MBC (72.2% vs 91.4%, p  = 0.03). Our data confirmed previous reported MBC characteristics: we found a higher risk of recurrence in MBC compared to FMC but similar OS. MBC and FMC are different entities and studies are needed to understand its epidemiology and guide its management.

Abstract 13950: Predicted Heart Mass and BMI: Evaluating Undersized Heart Transplantation in Obese vs. Non-Obese Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Samuel T Kim ◽  
Mark R Helmers ◽  
Peter Altshuler ◽  
Amit Iyengar ◽  
Jason Han ◽  
...  
Keyword(s):  
Propensity Score ◽  
Heart Transplantation ◽  
Propensity Score Matching ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Obese Patients ◽  
Heart Transplants ◽  
Term Survival ◽  
Heart Mass

Introduction: Although guidelines for heart transplant currently recommend against donors weighing ≥ 30% less than the recipient, recent studies have shown that the detriment of under-sizing may not be as severe in obese recipients. Furthermore, predicted heart mass (PHM) has been shown to be more reliable for size matching compared to metrics such as weight and body surface area. In this study, we use PHM to characterize the effects of undersized heart transplantation (UHT) in obese vs. non-obese recipients. Methods: Retrospective analysis of the UNOS database was performed for heart transplants from Jan. 1995 to Sep. 2020. Recipients were stratified by obese (BMI ≥ 30) and non-obese (30 > BMI ≥ 18.5). Undersized donors were defined as PHM ≥ 20% less than recipient PHM. Obese and non-obese populations separately underwent propensity score matching, and Kaplan-Meier estimates were used to graph survival. Multivariable Cox proportional-hazards analyses were used to adjust for confounders and estimate the hazard ratio for death attributable to under-sizing. Results: Overall, 50,722 heart transplants were included in the analysis. Propensity-score matching resulted in 2,214, and 1,011 well-matched pairs, respectively, for non-obese and obese populations. UHT in non-obese recipients resulted in similar 30-day mortality (5.7% vs. 6.3%, p = 0.38), but worse 15-year survival (38% vs. 35%, P = 0.04). In contrast, obese recipients with UHT saw similar 30-day mortality (6.4% vs. 5.5%, p = 0.45) and slightly increased 15-year survival (31% vs. 35%, P = 0.04). Multivariate Cox analysis showed that UHT resulted in an adjusted hazard ratio of 1.08 (95% CI 1.01 - 1.16) in non-obese recipients, and 0.87 (95% CI 0.78 - 0.98) in obese recipients. Conclusions: Non-obese patients with UHT saw worse long-term survival, while obese patients with UHT saw slightly increased survival. These findings may warrant reevaluation of the current size criteria for obese patients awaiting a heart.

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