scholarly journals The Efficacy of Chemotherapy in Survival of Esophageal Cancer With Bone Metastasis: A Propensity Score-Matched Analysis of The SEER Database

2021 ◽  
Author(s):  
junyuan chen ◽  
Jieruo Li ◽  
Tsz-Ngai Mok ◽  
Jiaquan Zhong ◽  
Guorong She ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Bone Metastasis ◽  
Propensity Score ◽  
Cancer Patients ◽  
Cox Regression ◽  
National Database ◽  
Cancer Specific Survival ◽  
Chemotherapy Group ◽  
Kaplan Meier ◽  
Significant Difference

Abstract Background The esophageal cancer patients with bone metastasis present with an extremely poor prognosis. The aim of this study was to establish a comprehensive insight into whether chemotherapy is justifiably being prescribed to esophageal cancer patients with bone metastasis. Methods A population-based retrospective study was conducted with data from the Surveillance, Epidemiology, and End Results (SEER) national database. By performing 1:1 paired match propensity score matching (PSM), we minimized the baseline discrepancies between groups. Univariate and multivariate Cox regression analyses were used to identify factors associated with survival. Kaplan–Meier survival curves were used to assess the effects of chemotherapy on survival. Results The final PSM cohort consisted of 730 patients, including 365 patients in the chemotherapy group and 365 patients in the non-chemotherapy group. There was a significant difference in overall survival (OS, p < 0.001) and cancer-specific survival (CSS, p < 0.001) between the two groups. The median OS time for the chemotherapy group was 9.8 (95% CI: 8.5–11.2) months, and it was decreased to 2.3 (95% CI 1.9–2.7) months in the non-chemotherapy group. Multivariate analysis confirmed that chemotherapy was an independent prognostic factor for OS (p < 0.001) and CSS (p < 0.001). Kaplan–Meier survival analysis suggested that chemotherapy could significantly improve OS (p < 0.001) and CSS (p < 0.001) both in squamous cell carcinoma or adenocarcinoma subgroup. However, there was no significant difference in both OS (p = 0.291) and CSS (p = 0.651) between the two groups for stage Ⅰ esophageal carcinoma. Conclusion Chemotherapy significantly improved OS and CSS in esophageal cancer patients with bone metastasis. However, chemotherapy might not improve the prognosis of grade I esophageal cancer.

scholarly journals Chemoradiotherapy Is Superior to Radiotherapy Alone in Esophageal Cancer Patients Older Than 65 Years: A Propensity Score-Matched Analysis of the SEER Database

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaojie Xia ◽  
Qing Gao ◽  
Xiaolin Ge ◽  
Zeyuan Liu ◽  
Xiaoke Di ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Rank Test ◽  
Seer Database ◽  
Cancer Specific Survival ◽  
Radiotherapy Group ◽  
Kaplan Meier ◽  
Radiotherapy Alone ◽  
Correlated Information

IntroductionRadiotherapy (RT) is the main treatment for unoperated esophageal cancer (EC) patients. It is controversial whether adding chemotherapy (CT) to RT is beneficial for elderly EC patients. The purpose of our study was to compare the efficacy of chemoradiotherapy (CRT) with RT alone for non-surgical elderly esophageal cancer patients.MethodsA total of 7,101 eligible EC patients older than 65 years diagnosed between 2000 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. All the samples were divided into the radiotherapy group and the chemoradiotherapy group. After being matched by propensity score matching (PSM) at a 1:1 ratio, 3,020 patients were included in our analysis. The Kaplan–Meier method and log-rank test were applied to compare overall survival (OS) and cancer-specific survival (CSS).ResultsAfter PSM, the clinical characteristics of patients between the RT and CRT groups were comparable. For EC patients older than 65 years, the 3-year OS and CSS in the CRT group were 21.8% and 27.4%, and the 5-year OS and CSS in the CRT group were 12.7% and 19.8%, respectively. The 3-year OS and CSS in the RT group were 6.4% and 10.4%, and the 5-year OS and CSS in the RT group were 3.5% and 7.2%, respectively. Next, these patients were divided into five subgroups based on the age stratification (ages 65–69; 70–74; 75–79; 80–84; ≥85). In each subgroup analysis, the 3- and 5-year OS and CSS showed significant benefits in the CRT group rather than in the RT group (all p &lt; 0.05). We were unable to assess toxicities between the two groups due to a lack of correlated information.ConclusionsCRT could improve OS and CSS for non-surgical EC patients older than 65 years. Adding chemotherapy to radiation showed a significant prognostic advantage for elderly esophageal cancer patients.

scholarly journals The prognosis of hepatoid adenocarcinoma of the stomach: a propensity score-based analysis

2020 ◽  
Author(s):  
Kai Zhou ◽  
Anqiang Wang ◽  
Sheng Ao ◽  
Jiahui Chen ◽  
Ke Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Rates ◽  
Cancer Type ◽  
Radical Gastrectomy ◽  
Hepatoid Adenocarcinoma ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Propensity Matching

Abstract Background : To investigate whether there is a distinct difference in prognosis between hepatoid adenocarcinoma of the stomach ( HAS) and non-hepatoid adenocarcinoma of the stomach (non-HAS) and whether HAS can benefit from radical surgery. Methods : We retrospectively reviewed 722 patients with non-HAS and 75 patients with HAS who underwent radical gastrectomy between 3 November 2009 and 17 December 2018. Propensity score matching (PSM) analysis was used to eliminate the bias among the patients in our study. The relationships between gastric cancer type and overall survival (OS) were evaluated by the Kaplan-Meier method and Cox regression. Results : Our data demonstrate that there was no statistically significant difference in the OS between HAS and non-HAS {K-M, P=log rank (Mantel-Cox), (before PSM P=0.397); (1:1 PSM P=0.345); (1:2 PSM P=0.195)}. Moreover, there were no significant differences in the 1-, 2-, or 3-year survival rates between patients with non-HAS and patients with HAS (before propensity matching, after 1:1 propensity matching, and after 1:2 propensity matching). Conclusion : HAS was generally considered to be an aggressive gastric neoplasm, but its prognosis may not be as unsatisfactory as previously believed.

Abstract TP209: Effect of Chemotherapy on Stroke Risk in Cancer Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Takaya Kitano ◽  
Tsutomu Sasaki ◽  
Yasufumi Gon ◽  
Kenichi Todo ◽  
Shuhei Okazaki ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Propensity Scores ◽  
Stroke Risk ◽  
Cox Regression ◽  
Treatment Plan ◽  
University Hospital ◽  
Chemotherapy Group ◽  
Kaplan Meier ◽  
Increased Risk ◽  
The Impact

Introduction: Chemotherapy may be a cause of cancer-associated stroke, but whether it increases stroke risk remains uncertain. We aimed to clarify the impact of chemotherapy on stroke risk in cancer patients. Methods: We investigated 27,932 patients enrolled in a hospital-based cancer registry at Osaka University Hospital between 2007 and 2015. The registry collects clinical data, including cancer status (site and stage), on all patients treated for cancer. Of them, 19,006 patients with complete data were included. A validated algorithm was used to identify stroke events within 2 years of cancer diagnosis. Patients were divided based on whether their initial treatment plan included chemotherapy. The association between chemotherapy and stroke was analyzed using the Kaplan-Meier method and stratified Cox regression. Results: Of the 19,006 patients, 5,887 (31%) patients were in the chemotherapy group. Non-targeted chemotherapy was used in 5,371 patients. Stroke occurred in 44 patients (0.75%) in the chemotherapy group and 51 patients (0.39%) in the no-chemotherapy group. Kaplan-Meier curve analysis showed that patients in the chemotherapy group had a higher stroke risk than patients in the no-chemotherapy group (HR 1.84; 95% CI 1.23-2.75; Figure [A]). However, this difference was insignificant after adjustment for cancer status using inverse probability of treatment weighting with propensity scores (HR 1.20; 95% CI 0.76-1.91; Figure [B]). Similarly, in the stratified Cox regression model, chemotherapy was not associated with stroke after adjustment for cancer status (HR 1.26; 95% CI 0.78-2.03). These findings were consistent with analysis wherein the effect of chemotherapy was treated as a time-dependent covariate (HR 1.02; 95% CI 0.55-1.88). Conclusions: In this population, the elevated stroke risk in cancer patients who received chemotherapy was presumably due to advanced cancer stage; chemotherapy was not associated with the increased risk of stroke.

scholarly journals Oncologic outcomes comparison of partial ureterectomy and radical nephroureterectomy for urothelial carcinoma

BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shengxian Li ◽  
Yuchen Pan ◽  
Jinghai Hu
Keyword(s):  
Cox Regression ◽  
Oncologic Outcomes ◽  
Radical Nephroureterectomy ◽  
Cancer Specific Survival ◽  
Urothelial Carcinomas ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Function Preservation ◽  
The Mean

Abstract Background The appropriate application of various treatment for upper tract urothelial carcinomas (UTUCs) is the key to prolong the survival of UTUC patients. Herein, we used data in our database to assess the oncological outcomes between partial ureterectomy (PU) and radical nephroureterectomy (RNU). Methods From 2007 to 2014, 255 patients with UTUC undergoing PU or RNU in our hospital database were investigated. Perioperative, postoperative data, and pathologic outcomes were obtained from our database. Cancer-specific survival (CSS) was assessed through the Kaplan-Meier method with Cox regression models to test the effect of these two surgery types. Results The mean length of follow-up was 35.8 months (interquartile range 10–47 months). Patients with high pT stage (pT2–4) suffered shorter survival span (HR: 9.370, 95% CI: 2.956–29.697, P < 0.001). There were no significant differences in CSS between PU and RNU (P = 0.964). In the sub-analysis, CSS for RNU and PU showed no significant difference for pTa–1 or pT2–4 tumor patients (P = 0.516, P = 0.475, respectively). Conclusions PU is not inferior to RNU in oncologic outcomes. Furthermore, PU is generally recognized with less invasive and better renal function preservation compared with RNU. Thus, PU would be rational for specific patients with UTUCs.

scholarly journals De Ritis Ratio (Aspartate Transaminase/Alanine Transaminase) as a Significant Prognostic Factor in Patients Undergoing Radical Cystectomy with Bladder Urothelial Carcinoma: A Propensity Score-Matched Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Hyeong Dong Yuk ◽  
Chang Wook Jeong ◽  
Cheol Kwak ◽  
Hyeon Hoe Kim ◽  
Ja Hyeon Ku
Keyword(s):  
Prognostic Factor ◽  
Propensity Score ◽  
Radical Cystectomy ◽  
Cox Regression ◽  
Alanine Transaminase ◽  
Significant Prognostic Factor ◽  
Aspartate Transaminase ◽  
Cancer Specific Survival ◽  
T Stage ◽  
Kaplan Meier

Introduction. To investigate the correlation between preoperative De Ritis ratio (aspartate transaminase (AST)/alanine transaminase (ALT)) and postoperative outcome in patients with urothelial cell carcinoma (UC) treated with radical cystectomy. Materials and Methods. We analyzed the clinical and pathological data of 771 patients who underwent radical cystectomy for bladder UC. Patients were divided into two groups according to the optimal value of AST/ALT ratio. The effect of the AST/ALT ratio was analyzed using the Kaplan–Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS). In addition, propensity score matching of 1 : 1 was performed between the two groups. Results. Median follow-up was 84.0 (36–275) months. Mean age was 64.8±10.0 years. According to the receiver operating characteristic (ROC) analysis, the optimal threshold of the AST/ALT ratio was 1.1. In Kaplan–Meier analyses, the high AST/ALT group showed worse outcomes in CSS and OS (all P<0.001). Also, RFS (P=0.001) in the Cox regression models of clinical and pathological parameters was used to predict CSS, OS, and AST/ALT ratio (HR 2.15, 95% CI 1.23-3.73, P=0.007) and pathological T stage (HR 4.80, 95% CI 1.19-19.28, P=0.003). To predict OS and AST/ALT ratio (HR 2.05, 95% CI 1.65–2.56, P<0.001), pathological T stage (HR 2.96, 95% CI 0.57–17.09, P=0.037) and positive lymph node (HR 1.71, 95% CI 1.50–1.91, P=0.021) were determined as independent prognostic factors. Conclusion. Preoperative AST/ALT ratio could be an independent prognostic factor in patients with UC treated with radical cystectomy.

scholarly journals Presentation and Survival by Hormonal Receptor Status in Metaplastic Breast Cancer: A Propensity Score-matched Analysis

2021 ◽  
Author(s):  
Siqin Wang ◽  
Jin Hu ◽  
yanting Zhang ◽  
Jian Shen ◽  
Fang Dong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
High Risk ◽  
Propensity Score ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Metaplastic Breast Cancer ◽  
Cancer Specific Survival ◽  
Hormonal Receptor ◽  
Kaplan Meier ◽  
Significant Difference

Abstract Background: Studies reported the hormonal receptor (HR) status was not associated with survival in metaplastic breast cancer (MBC). In addition, MBC patients cannot benefit from chemotherapy (CT). The present study aimed to evaluate the efficacy of CT on MBC patients with high risk (T1-4N2-3M0 and T4N0-1M0) by propensity-score matching (PSM). Methods: A retrospective study was performed to analyze MBC from the SEER database. Breast cancer-specific survival (BCSS) rates were analyzed using the Kaplan–Meier curve and differences assessed by log-rank tests. Cox proportional hazard models were used to assess BCSS. PSM was used to make 1:1 case-control matching.Results: We identified 3116 patients. The median follow-up time was 44 months (range, 1–321 months). 23.0% of patients were HR-positive. About 62.5% of patients received CT, which seem not to relate to HR status. Recurrence risk had a significant difference between HR-negative and HR-positive groups. In the multivariable Cox proportional hazards regression model, HR status was not associated with a better BCSS. CT had no benefit for MBC. Multivariate analyses after PSM (n=1274) confirmed that both CT and HR status were not associated with prognosis. The Kaplan–Meier curve before PSM showed that HR-negative MBC with intermediate-risk benefited from CT. For HR-positive MBC, patients with intermediate and high risk benefited from CT. However, CT could only benefit for HR-positive MBC with high risk after PSM.Conclusion: PSM analysis showed that CT could only benefit for HR-positive MBC with high risk.

Adjuvant chemotherapy of cisplatin, 5-fluorouracil (5-FU) plus leucovorin (LV) for esophageal cancer: A case-matched cohort study in east china

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15135-15135
Author(s):  
J. Zhang ◽  
J. Xiang ◽  
Y. Zhang ◽  
X. Zhou
Keyword(s):  
Esophageal Cancer ◽  
Adjuvant Chemotherapy ◽  
Randomized Clinical Trials ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Treatment Result ◽  
Chemotherapy Group ◽  
Study Results ◽  
Significant Difference

15135 Background: There are very few prospective randomized clinical trials regarding the adjuvant chemotherapy of esophageal cancer. This study is to compare the survival between the patients who received adjuvant chemotherapy of cisplatin, 5-Fluorouracil (5-FU) plus leucovorin (LV) and those who did not. Methods: Between 1998 and 2004, 90 esophageal cancer patients with adjuvant chemotherapy, and clinic-pathologically well- matched 180 patients without chemotherapy, were included in this study. Results: There was no significant difference for disease-free-survival and overall-survival in stage I (P=0.59&p=0.59), stage II (P=0.2778&P=0.2778) and stage III patients (P=0.695 &P=0.8667) between observation group and chemotherapy group. Chemotherapy was most effective for the patients who had metastasis in cervical and /or celiac lymph node (IVa subgroup) by both univariate analysis and multivariate COX regression model. 1 and 3-year DFS and OS are significantly better than those who did not receive the chemotherapy(P= 0.038,and 0.01, respectively). Among the factors evaluated by immunohistochemical staining, Bcl-2 expression in the primary tumor was a worse prognostic factor, and was more predictive in adjuvant chemotherapy group than no chemotherapy group. Conclusions: Adjuvant chemotherapy significantly improved the treatment result of stage IVa patients. Bcl-2 could be potentially used to analyze the prognosis and guild the adjuvant treatment in esophageal cancer. No significant financial relationships to disclose.

The Effect of Chemotherapy on Stroke Risk in Cancer Patients

2020 ◽  
Vol 120 (04) ◽  
pp. 714-723
Author(s):  
Takaya Kitano ◽  
Tsutomu Sasaki ◽  
Yasufumi Gon ◽  
Kenichi Todo ◽  
Shuhei Okazaki ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Propensity Scores ◽  
Stroke Risk ◽  
Cox Regression ◽  
Treatment Plan ◽  
University Hospital ◽  
Chemotherapy Group ◽  
Kaplan Meier ◽  
Increased Risk ◽  
Advanced Cancer Stage

Abstract Background Chemotherapy may be a cause of cancer-associated stroke, but whether it increases stroke risk remains uncertain. We investigated how chemotherapy affects stroke risk in cancer patients. Methods Of 27,932 patients in a hospital-based cancer registry (which contains clinical data on all patients treated for cancer at Osaka University Hospital) screened between 2007 and 2015, medical records of 19,006 patients with complete data were investigated. A validated algorithm was used to identify stroke events within 2 years of cancer diagnosis. Patients were divided based on whether their initial treatment plan included chemotherapy. The association between chemotherapy and stroke was analyzed using the Kaplan–Meier method and stratified Cox regression. Results Of 19,006 patients, 5,887 (31%) were in the chemotherapy group. Stroke occurred in 44 (0.75%) and 51 (0.39%) patients in the chemotherapy and nonchemotherapy group, respectively. Kaplan–Meier curve analysis showed that patients in the chemotherapy group had a higher stroke risk than those in the nonchemotherapy group (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23–2.75). However, this difference was insignificant after adjustment for cancer status using inverse probability of treatment weighting with propensity scores (HR 1.20; 95% CI 0.76–1.91). Similarly, in the stratified Cox regression model, chemotherapy was not associated with stroke after adjustment for cancer status (HR 1.26; 95% CI 0.78–2.03). Conclusion In our study, the elevated stroke risk in cancer patients who received chemotherapy was presumably due to advanced cancer stage; chemotherapy was not associated with the increased risk of stroke.

scholarly journals The prognosis of hepatoid adenocarcinoma of the stomach: a propensity score-based analysis

2020 ◽  
Author(s):  
Kai Zhou ◽  
Anqiang Wang ◽  
Sheng Ao ◽  
Jiahui Chen ◽  
Ke Ji ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Hepatoid Adenocarcinoma ◽  
Chi Square ◽  
Clinical Indicators ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Propensity Matching

Abstract Background To investigate whether there is a distinct difference in prognosis between hepatoid adenocarcinoma of the stomach (HAS) and non-hepatoid adenocarcinoma of the stomach (non-HAS) and whether HAS can benefit from radical surgery. Methods We retrospectively reviewed 722 patients with non-HAS and 75 patients with HAS who underwent radical gastrectomy between 3 November 2009 and 17 December 2018. Propensity score matching (PSM) analysis was used to eliminate the bias among the patients in our study. First, univariate analysis, including the chi-square and Mann-Whitney U tests, was used to investigate the relationship between all included clinical indicators and dependent variables, and some clinical indicators that might be meaningless were excluded. Then, clinical indicators with statistical and clinical significance were included in the logistic regression analysis to obtain more reliable results. The relationships between gastric cancer types and overall survival (OS) were evaluated by the Kaplan-Meier method and Cox regression models. Results Our data demonstrate that there is no statistically significant difference in the OS between HAS and non-HAS {K-M, P=log rank (Mantel-Cox), (before PSM P=0.490); (1:1 PSM P=0.345); (1:2 PSM P=0.195)}. Moreover, there were no significant differences in the 1-, 2-, or 3-year survival rates between patients with non-HAS and patients with HAS (before propensity matching, after 1:1 propensity matching, and after 1:2 propensity matching). Conclusion HAS is generally considered to be an aggressive gastric neoplasm, but its prognosis may not be as unsatisfactory as previously believed.

scholarly journals The risk and prognostic factors for brain metastases in esophageal cancer patients: an analysis of the SEER database

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shizhao Cheng ◽  
Lei Yang ◽  
Xin Dai ◽  
Jing Wang ◽  
Xingpeng Han
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Factors ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Alaska Native ◽  
Cox Regression ◽  
Lung Metastases ◽  
Seer Database ◽  
Kaplan Meier ◽  
The Brain

Abstract Background Brain metastases were rare in esophageal cancer patients. Using the Surveillance, Epidemiology, and End Results (SEER) database, the present study investigated the incidence, risk and prognostic factors of brain metastases in esophageal cancer patients. Methods Retrieving esophageal cancer patients diagnosed between 2010 and 2018 from the SEER database, univariable and multivariable logistic and cox regression models were used to investigate the risk factors for brain metastases development and prognosis, respectively. The brain metastases predicting nomogram was constructed, evaluated and validated. The overall survival (OS) of patients with brain metastases was analyzed by Kaplan–Meier method. Results A total of 34,107 eligible esophageal cancer patients were included and 618 of them were diagnosed with brain metastases (1.8%). The median survival of the brain metastatic esophageal cancer patients was 5 (95% CI: 5–7) months. The presence of bone metastases and lung metastases were the homogeneously associated factors for the development and prognosis of brain metastases in esophageal cancer patients. Patients younger than 65 years, American Indian/Alaska Native race (vs. White), overlapping lesion (vs. Upper third), esophageal adenocarcinoma histology subtype, higher N stage, and liver metastases were positively associated with brain metastases occurrence. The calibration curve, ROC curve, and C-index exhibited good performance of the nomogram for predicting brain metastases. Conclusions Homogeneous and heterogeneous factors were found for the development and prognosis of brain metastases in esophageal cancer patients. The nomogram had good calibration and discrimination for predicting brain metastases.

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