scholarly journals Effect of Ulceration on the Therapeutic Benefit of Surgery in Patients with Stage IV Melanoma: A Surveillance, Epidemiology, and End Results Analysis from 2004–2015

2020 ◽  
Author(s):  
Qiqi Zhao ◽  
Zeyun Gao ◽  
Xuezhu Xu
Keyword(s):  
Malignant Melanoma ◽  
Primary Tumor ◽  
Proportional Hazards ◽  
Tumor Resection ◽  
Stage Iv ◽  
Therapeutic Benefit ◽  
Cox Proportional Hazards ◽  
Primary Tumor Resection ◽  
Survival Times ◽  
Resection Group

Abstract Background: The effects of various surgical options and ulcerations on the survival of patients with stage IV skin malignant melanoma are unknown. Therefore, we evaluated the potential of these factors as prognostic markers in patients with stage IV malignant melanoma. Methods: We included 5760 patients from 2004–2015 who are screened from the SEER datasets in the study. The patients were divided into four groups: the R 0 group, the primary tumor resection group, the metastasectomy group, and the no-resection group. The median follow-up survival time and overall survival were compared between the four groups as primary outcomes. Result: The R0 , primary tumor resection, metastasectomy, and no-resection groups had median survival times of 11, 13, 20, and 4 months, respectively ( p <0.001). Cox (proportional hazards) regression models estimated that patients in the R 0 , primary tumor resection, and metastasectomy groups had longer survival benefits, with hazard ratios of 0.396 (95% confidence interval [CI], 0.347–0.453), 0.509 (95% CI, 0.465–0.556), and 0.481 (95% CI, 0.447–0.519), respectively. Conclusion: We highlight the importance of surgery in metastatic melanoma; each surgical group in this study is independently correlated with increased survival. In addition, the patient’s ulceration status is able to predict surgical treatment; however, in the ulcerated melanoma cases, caution should be exercised when considering a metastasectomy.

scholarly journals Comparative effectiveness of primary tumor resection in patients with stage IV colon cancer

Cancer ◽  
2016 ◽  
Vol 123 (7) ◽  
pp. 1124-1133 ◽  
Author(s):  
Zeinab Alawadi ◽  
Uma R. Phatak ◽  
Chung-Yuan Hu ◽  
Christina E. Bailey ◽  
Y. Nancy You ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Primary Tumor ◽  
Comparative Effectiveness ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection

A Novel Derivation Predicting Survival After Primary Tumor Resection in Stage IV Colorectal Cancer

2017 ◽  
Vol 60 (9) ◽  
pp. 895-904 ◽  
Author(s):  
Winson Jianhong Tan ◽  
Sreemanee Raaj Dorajoo ◽  
Madeline Yen Min Chee ◽  
Wah Siew Tan ◽  
Fung Joon Foo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer

scholarly journals Role of Primary Tumor Resection Among Chemotherapy-Treated Patients with Synchronous Stage IV Colorectal Cancer: A Survival Analysis

2013 ◽  
Vol 18 (3) ◽  
pp. 592-598 ◽  
Author(s):  
Walter Y Tsang ◽  
Argyrios Ziogas ◽  
Bruce S. Lin ◽  
Tara E. Seery ◽  
William Karnes ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Survival Analysis ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Colorectal Cancer

Primary tumor resection in patients with stage IV breast cancer: 10‐year experience

2021 ◽  
Author(s):  
Malke Asaad ◽  
Jennifer A. Yonkus ◽  
Tanya L. Hoskin ◽  
Tina J. Hieken ◽  
James W. Jakub ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Tumor ◽  
Tumor Resection ◽  
Stage Iv ◽  
Primary Tumor Resection ◽  
Stage Iv Breast Cancer

scholarly journals Association of a Palliative Surgical Approach to Stage IV Pancreatic Neuroendocrine Neoplasms with Survival: A Systematic Review and Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2246
Author(s):  
Marina Tsoli ◽  
Maria-Eleni Spei ◽  
Göran Wallin ◽  
Gregory Kaltsas ◽  
Kosmas Daskalakis
Keyword(s):  
Random Effects ◽  
Primary Tumor ◽  
Survival Benefit ◽  
Tumor Resection ◽  
Stage Iv ◽  
Distant Metastases ◽  
Primary Tumor Resection ◽  
Cochrane Library ◽  
Neuroendocrine Neoplasms ◽  
Pancreatic Neuroendocrine Neoplasms

The role of primary tumor resection in patients with pancreatic neuroendocrine neoplasms (PanNENs) and unresectable distant metastases remains controversial. We aimed to evaluate the effect of palliative primary tumor resection (PPTR) on overall survival (OS) in this setting. We searched the MEDLINE, Embase, Cochrane Library, Web of Science and SCOPUS databases up to January 2020 and used the Newcastle–Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5661 articles were screened. In 10 studies, 5551 unique patients with stage IV PanNEN and unresectable metastases were included. The five-year OS for PanNEN patients undergoing PPTR in stage IV was 56.6% vs. 23.9% in the non-surgically treated patients (random effects relative risk (RR): 1.70; 95% CI: 1.53–1.89). Adjusted analysis of pooled hazard ratios (HR) confirmed longer OS in PanNEN patients undergoing PPTR (random effects HR: 2.67; 95% CI: 2.24–3.18). Cumulative OS analysis confirmed an attenuated survival benefit over time. The complication rate of PPTR was as high as 27%. In conclusion, PPTR may exert a survival benefit in stage IV PanNEN. However, the included studies were subject to selection bias, and special consideration should be given to PPTR anchored to a multimodal treatment strategy. Further longitudinal studies are warranted, with long-term follow-up addressing the survival outcomes associated with surgery in stage IV disease.

Utilization and outcomes of primary tumor surgery for stage IV colon cancer in the United States: A population-based study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 3542-3542
Author(s):  
Yvonne Sada ◽  
Zhigang Duan ◽  
Hashem El-Serag ◽  
Jessica Davila
Keyword(s):  
Colon Cancer ◽  
Logistic Regression ◽  
Primary Tumor ◽  
Proportional Hazards ◽  
Stage Iv ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Tumor Surgery ◽  
Cancer Specific Survival ◽  
Co Morbidity

3542 Background: Stage IV colon cancer treatment may include resection of the primary tumor. Current use of primary tumor surgery (PTS) in clinical practice is unknown. This study examined utilization and determinants of PTS and evaluated its effect on survival. Methods: Using national Surveillance, Epidemiology, and End Results registry data, stage IV colon cancer patients diagnosed from 1998-2008 were identified. Data on demographics, PTS, and tumor features were collected. Temporal changes in receipt of PTS were examined over 3 periods (1998-2000, 2001-2004, 2005-2008). Multiple logistic regression was used to identify significant determinants of PTS. 1- and 3-year cancer-specific survival was calculated in PTS and non-PTS patients. Cox proportional hazards models examined the effect of PTS on mortality risk. Results: 16,029 patients were identified. Median age was 69 (IQR: 57-78), and 50% were male. Approximately 67% of patients received PTS. Receipt of PTS significantly declined from 72% in 1998-2000 to 68% in 2001-2004, and 63% in 2005-2008 (p<0.01). Results from the logistic regression analysis showed that patients who were younger, white, married, had right sided cancer and higher tumor grade were more likely to receive PTS (all p<0.01). The 1- and 3-year survival was higher in patients who received PTS compared with those who did not (1-year: 55% (95% CI: 54-56) vs. 24% (95% CI: 23-26); 3-year: 19% (95% CI: 19-20) vs. 4% (95%CI: 3.4-4.9)). Adjusted for demographics and tumor features, risk of mortality was 54% (HR=0.46; 95% CI: 0.44-0.48) lower in patients who received PTS than those without PTS. Recent year of diagnosis (HR=0.88; 95% CI: 0.75-0.80) and being married (HR=0.90, 95% CI: 0.86-0.95) were associated with lower mortality. Older age (HR=1.48; 95% CI: 1.39-1.56), black race (HR=1.09; 95% CI: 1.03-1.15), right sided cancer (HR=1.21; 95% CI: 1.17-1.26), and poorly differentiated tumors (HR= 1.62; 95% CI: 1.46-1.80) were associated with increased mortality. Conclusions: PTS utilization for stage IV colon cancer has significantly declined, yet survival was higher in patients who received PTS. However, these findings are limited by the absence of co-morbidity and chemotherapy data.

Sign in / Sign up

Export Citation Format

Share Document