scholarly journals How to Choose the Best Procedure Type for Duodenal Neuroendocrine Tumors With a Maximum Diameter of 1 to 2 Cm a Propensity Score Matching Analysis Based on the SEER Database

2020 ◽  
Author(s):  
Huanyu Tang ◽  
jiebin xie ◽  
Yueshan Pang ◽  
Xia Hua ◽  
xun Li
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Treatment Plan ◽  
Clinicopathological Characteristics ◽  
Maximum Diameter ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Significant Difference ◽  
Duodenal Neuroendocrine Tumors

Abstract Background: The treatment plan for duodenal neuroendocrine tumors (d-NETs) with a diameter between 1 and 2 cm is still controversy. Aim: To compare the effects of local endoscopic resection and radical resection on the prognosis of d-NETs with a maximum diameter of 1-2 cm. Methods: 286 eligible patients were identified from the SEER database. Propensity score matching (PSM) was done to match patients 1:1 on clinicopathological characteristics. Kaplan-Meier analysis was used to analyze the factors affecting the prognosis.Results: Before PSM, there was no significant difference in the cancer-specific survival (CSS) between the two groups (P = 0.595), but the tumor size, T stage, N stage, and M stage were significantly different between the two groups (all P < 0.05). After 1:1 PSM, the differences in clinicopathological characteristics between the two groups were significantly reduced (all P > 0.05). Survival analysis showed that only the tumor grade was correlated with the prognosis (P = 0); surgical method and other clinicopathological characteristics were not correlated with the prognosis (all P > 0.05). Conclusion: The surgical approach had no significant effect on the prognosis of d-NET patients with a maximum diameter of 1-2 cm and without lymph node metastasis.

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 Short-term Outcomes of Robotic- versus Laparoscopic-Assisted Total Gastrectomy for Advanced Gastric Cancer: A Propensity Score Matching Study

2019 ◽  
Author(s):  
Changdong Yang ◽  
Yan Shi ◽  
Shaohui Xie ◽  
Jun Chen ◽  
Yongliang Zhao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Propensity Score Matching ◽  
Total Gastrectomy ◽  
Resection Margin ◽  
Operation Time ◽  
Clinicopathological Characteristics ◽  
Short Term ◽  
Significant Difference

Abstract Background Few studies have been designed to evaluate the short-term outcomes for advanced gastric cancer (AGC) between robotic-assisted total gastrectomy (RATG) and laparoscopy-assisted total gastrectomy (LATG) alone. The purpose of this study was to assess short-term outcomes of RATG compared with LATG for AGC.Methods We retrospectively evaluated 116 and 244 patients who underwent RATG or LATG respectively. Besides, we performed a propensity score matching (PSM) analysis between RATG and LATG for clinicopathological characteristics to reduce bias and compared short-term surgical outcomes.Results After PSM, the RTAG group had longer mean operation time (291.09±58.41 vs. 271.99±48.41min, p=0.007), less intraoperative bleeding (151.98±92.83 vs. 172.59±97.01ml, p=0.032) and more N2 tier RLNs (9.33±5.46 vs. 7.50±3.86, p=0.018) than the LATG group. Besides, the total RLNs of RATG was at the brink of significance compared to LATG (35.09±12.93 vs.32.34±12.05, p=0.062). However, no significant differences were found between the two groups in terms of length of incision, proximal resection margin, distal resection margin, postoperative hospital stay. The conversion rate was 4.92% and 8.61% in the RATG and LATG groups, respectively, with no significant difference. The ratio of splenectomy was 1.7% and 0.4% respectively. There was no significant difference in overall complication rate between RATG and LATG groups before PSM (24.1% vs. 28.7%; p=0.341) and after PSM (24.1% vs. 33.6%; p=0.102). The grade II complications accounted for most of all complications in the two cohorts both before and after PSM.Conclusion This study demonstrates that RATG is comparable to LATG in terms of short-term surgical outcomes.

scholarly journals Pelvic lymph node dissection and its extent on survival benefit in prostate cancer patients with a risk of lymph node invasion >5%: a propensity score matching analysis from SEER database

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Junru Chen ◽  
Zhipeng Wang ◽  
Jinge Zhao ◽  
Sha Zhu ◽  
Guangxi Sun ◽  
...  
Keyword(s):  
Lymph Node ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Lymph Node Dissection ◽  
Cox Regression ◽  
Pelvic Lymph Node Dissection ◽  
Pelvic Lymph Node ◽  
Seer Database ◽  
Node Dissection ◽  
Significant Difference

AbstractPelvic lymph node dissection (PLND) represents the gold standard for nodal staging in PCa and is recommended for patients with a probability of lymph node invasion (LNI) >5%. However, the therapeutic role of PLND and its extent remains a debate. In this study, data of 20,668 patients treated with radical prostatectomy (RP) with and without PLND from SEER database between 2010 and 2015 were retrospectively analyzed. All patients had a risk of LNI >5% according to 2012-Briganti nomogram. Propensity score matching (PSM) was performed to balance baseline characteristics between patients with and without PLND. Kaplan-Meier curves and Cox regression were used to evaluate the impacts of the PLND and its extent on cancer-specific survival (CSS) and overall survival (OS). In overall cohort, patients with PLND were associated with more aggressive clinicopathologic characteristics and had poorer survival compared to those without PLND (5-year CSS rate: 98.4% vs. 99.7%, p < 0.001; 5-year OS rate: 96.3% vs. 97.8%, p < 0.001). In the post-PSM cohort, no significant difference in survival was found between patients with and without PLND (5-year CSS rate: 99.4% vs. 99.7%, p = 0.479; 5-year OS rate: 97.3% vs. 97.8%, p = 0.204). In addition, the extent of PLND had no impact on prognosis (all p > 0.05). Subgroup analyses reported similar negative findings. In conclusion, neither PLND nor its extent was associated with survival in North American patients with a risk of LNI >5%. The cut-off point of 5% probability of LNI might be too low to show benefits in survival in patients underwent PLND.

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 &lt; 0.001), and the estimated blood loss was also significantly lesser (P &lt; 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 Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors

2021 ◽  
Vol 28 ◽  
pp. 107327482098682
Author(s):  
Min Shi ◽  
Biao Zhou
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumors ◽  
Early Onset ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Clinicopathological Characteristics ◽  
Pancreatic Neuroendocrine Tumors ◽  
Chi Square ◽  
Younger Patients ◽  
Significant Difference

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

scholarly journals Empiric use of anticoagulation in hospitalized patients with COVID-19: a propensity score-matched study of risks and benefits

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Bo Yu ◽  
Victor Perez Gutierrez ◽  
Alex Carlos ◽  
Gregory Hoge ◽  
Anjana Pillai ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Major Bleeding ◽  
Risk Estimation ◽  
Large Population ◽  
Invasive Mechanical Ventilation ◽  
Bleeding Risk ◽  
Hospitalized Patients ◽  
Significant Difference

Abstract Background Hospitalized patients with COVID-19 demonstrate a higher risk of developing thromboembolism. Anticoagulation (AC) has been proposed for high-risk patients, even without confirmed thromboembolism. However, benefits and risks of AC are not well assessed due to insufficient clinical data. We performed a retrospective analysis of outcomes from AC in a large population of COVID-19 patients. Methods We retrospectively reviewed 1189 patients hospitalized for COVID-19 between March 5 and May 15, 2020, with primary outcomes of mortality, invasive mechanical ventilation, and major bleeding. Patients who received therapeutic AC for known indications were excluded. Propensity score matching of baseline characteristics and admission parameters was performed to minimize bias between cohorts. Results The analysis cohort included 973 patients. Forty-four patients who received therapeutic AC for confirmed thromboembolic events and atrial fibrillation were excluded. After propensity score matching, 133 patients received empiric therapeutic AC while 215 received low dose prophylactic AC. Overall, there was no difference in the rate of invasive mechanical ventilation (73.7% versus 65.6%, p = 0.133) or mortality (60.2% versus 60.9%, p = 0.885). However, among patients requiring invasive mechanical ventilation, empiric therapeutic AC was an independent predictor of lower mortality (hazard ratio [HR] 0.476, 95% confidence interval [CI] 0.345–0.657, p < 0.001) with longer median survival (14 days vs 8 days, p < 0.001), but these associations were not observed in the overall cohort (p = 0.063). Additionally, no significant difference in mortality was found between patients receiving empiric therapeutic AC versus prophylactic AC in various subgroups with different D-dimer level cutoffs. Patients who received therapeutic AC showed a higher incidence of major bleeding (13.8% vs 3.9%, p < 0.001). Furthermore, patients with a HAS-BLED score of ≥2 had a higher risk of mortality (HR 1.482, 95% CI 1.110–1.980, p = 0.008), while those with a score of ≥3 had a higher risk of major bleeding (Odds ratio: 1.883, CI: 1.114–3.729, p = 0.016). Conclusion Empiric use of therapeutic AC conferred survival benefit to patients requiring invasive mechanical ventilation, but did not show benefit in non-critically ill patients hospitalized for COVID-19. Careful bleeding risk estimation should be pursued before considering escalation of AC intensity.

scholarly journals Chemoembolization Plus Radiotherapy versus Chemoembolization Plus Sorafenib for the Treatment of Hepatocellular Carcinoma Invading the Portal Vein: A Propensity Score Matching Analysis

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1116 ◽  
Author(s):  
Hee Ho Chu ◽  
Jin Hyoung Kim ◽  
Ju Hyun Shim ◽  
Sang Min Yoon ◽  
Pyeong Hwa Kim ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Portal Vein ◽  
Propensity Score Matching ◽  
Combined Treatment ◽  
Correct Selection ◽  
Advanced Hepatocellular Carcinoma ◽  
Entire Study ◽  
Treatment Type ◽  
Significant Difference

A combination of transarterial chemoembolization (TACE) plus sorafenib or radiotherapy (RT) has demonstrated efficacy in patients with advanced hepatocellular carcinoma (HCC). Here, the two combined treatment approaches were compared in patients with HCC and portal vein tumor thrombus (PVTT). Data from 307 patients treated with TACE plus RT (n = 203) or TACE plus sorafenib (n = 104) as first-line treatment for HCC with PVTT were retrospectively evaluated. Using the propensity model to correct selection bias, 87 patients were included from each treatment group. During follow up (median, 12 months) in the entire study population, the median progression-free survival (PFS) and overall survival (OS) were significantly longer in the TACE plus RT group than in the TACE plus sorafenib group (6.5 vs. 4.3 months, respectively; p = 0.017 and 16.4 vs. 12 months, respectively; p = 0.007). Following propensity score matching, the median PFS and OS in the two groups showed no statistically significant difference. Multivariable analysis found no significant association between PFS or OS and the treatment type. In conclusion, this retrospective study of data from patients with advanced HCC with PVTT shows that PFS and OS did not differ significantly in patients treated with TACE plus RT and TACE plus sorafenib.

Abstract 17088: In-Hospital Complications and Outcomes of Leadless Pacemaker Implantation: A Propensity-Score Matched Analysis From Nationwide Database

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Moghniuddin Mohammed ◽  
Amit Noheria ◽  
Seth Sheldon ◽  
Madhu Reddy
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Real World ◽  
Electronic Device ◽  
Artery Bypass ◽  
Pacemaker Implantation ◽  
Leadless Pacemaker ◽  
Ventricular Lead ◽  
Significant Difference ◽  
Before And After

Introduction: There are no randomized controlled trials that compared the outcomes of leadless pacemaker (L-PPM) implantation with transvenous pacemaker (TV-PPM) and there is scarcity of data on real world outcomes. Methods: We queried National Inpatient Sample to identify all adult patients who had primary discharge diagnosis of conduction disorders or tachy-arrhythmias and excluded patients who had a concomitant procedure for valve replacement, coronary artery bypass grafting, ablation and/or cardiac implantable electronic device removal so that complications can be attributed to the pacemaker implantation. We included only procedures from November 2016 to December 2017 as Micra was the only available L-PPM during that period. For the comparison cohort we selected patients, during the same time period, who had a procedure code for single chamber pacemaker implantation in conjunction with right ventricular lead placement. We performed 1:1 propensity score matching and the variables used for matching are marked with asterisk in Table 1. All the codes used to identify complications has been previously validated from the Micra Post-approval registry and Coverage with Evidence Study. Results: Total of 1,305 patients for L-PPM and 13,905 patients in the TV-PPM group were included. Baseline characteristics with standardized mean difference before and after matching are shown in Table 1. Briefly, patients in L-PPM group were younger but had higher co-morbidities compared to TV-PPM group. The complications before and after matching are shown in Table 2. Conclusions: In conclusion, we found no significant difference between in-hospital complications after propensity score matching, with the exception of deep venous thrombosis. There was no difference between length of stay but cost for L-PPM was significantly higher. In this real-world analysis, we found that the leadless PPM implantation is safe in comparison to transvenous PPM.

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