The Safety of Ovarian Preservation in Stage I Endometrial Endometrioid Adenocarcinoma Based on Propensity Score Matching

2017 ◽  
Vol 20 (7) ◽  
Author(s):  
Ting Hou ◽  
Yidi Sun ◽  
Junyi Li ◽  
Chenglin Liu ◽  
Zhen Wang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Stage I ◽  
Endometrioid Adenocarcinoma ◽  
Ovarian Preservation ◽  
Endometrial Endometrioid Adenocarcinoma

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.

Outcome analysis of chemotherapy duration for resected stage I-II and unresected stage III pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 375-375
Author(s):  
Sung Jun Ma ◽  
Austin J Iovoli ◽  
Kavitha M Prezzano ◽  
Gregory Hermann ◽  
Lucas M Serra ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Advanced Pancreatic Cancer ◽  
Stage I ◽  
Stage Iii ◽  
Outcome Analysis ◽  
Resected Stage

375 Background: For resected early-stage pancreatic cancer, RTOG 9704 has evaluated the outcome of 3 weeks of adjuvant chemotherapy (C) followed by chemoradiation (CRT) and post-CRT C. For locally advanced pancreatic cancer, a recent literature review showed that the typical duration for induction C is between 1 and 6 months prior to CRT. The ideal duration of C prior to CRT remains unclear. This National Cancer Database (NCDB) study was performed to identify the optimal duration of C prior to CRT in patients with pancreatic cancer. Methods: The NCDB was queried for primary stage I-II, cT1-3N0-1M0, resected and stage III, cT4N0-1M0, unresected pancreatic adenocarcinoma treated with C+CRT (2004-2015). Cohorts I-II and III included stage I-II and stage III cases, respectively. In each cohort, the patients were stratified by the short (short C) and long duration (long C) of chemotherapy based on their median durations (70 and 90 days between the onset of chemotherapy and radiation for cohorts I-II and III, respectively). Baseline patient, tumor, and treatment characteristics were examined. The primary endpoint was overall survival (OS). Kaplan-Meier analysis, multivariable Cox proportional hazards method, and propensity score matching were used. Results: Among 1,577 patients, cohort I-II had 839 patients (n = 409 with short C, n = 430 with long C) and cohort III had 738 patients (n = 360 with short C, n = 378 with long C). Median follow-up was 39.5 months and 24.3 months for cohorts I-II and III, respectively. The long C group showed improved OS in the multivariable analysis in both cohort I-II (HR 0.72, p < 0.001) and cohort III (HR 0.83, p = 0.025). Using 1:1 propensity score matching, a total of 610 patients for cohort I-II and 542 patients for cohort III were matched. After matching, long C remained statistically significant for improved OS compared with short C in both cohort I-II (median OS 26.1 vs 21.9 months, p = 0.003) and cohort III (median OS 16.7 vs 14.2 months, p = 0.021). Conclusions: Our NCDB study using propensity score matched analysis showed a survival benefit in the use of longer duration chemotherapy compared to shorter duration chemotherapy for both resected stage I-II and unresected stage III pancreatic cancer.

Surgery or stereotactic body radiotherapy for elderly stage I lung cancer? A propensity score matching analysis

Surgery Today ◽  
2017 ◽  
Vol 47 (12) ◽  
pp. 1476-1483 ◽  
Author(s):  
Takuro Miyazaki ◽  
Takuya Yamazaki ◽  
Daisuke Nakamura ◽  
Shuntaro Sato ◽  
Naoya Yamasaki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Stereotactic Body Radiotherapy ◽  
Stage I ◽  
Propensity Score Matching Analysis ◽  
Stage I Lung Cancer

Comparison of adjuvant chemotherapy, chemoradiation, and chemotherapy followed by chemoradiation for resected stage I-II pancreatic cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 372-372
Author(s):  
Sung Jun Ma ◽  
Gregory Hermann ◽  
Kavitha M Prezzano ◽  
Lucas M Serra ◽  
Austin J Iovoli ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Multivariable Analysis ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Concurrent Chemoradiation ◽  
Forest Plot

372 Background: Prior National Cancer Database (NCDB) studies have demonstrated an overall survival (OS) benefit for adjuvant concurrent chemoradiation (CRT) compared to chemotherapy alone. Given the more recent adoption of postoperative chemotherapy followed by concurrent chemoradiation (C+CRT), this NCDB analysis evaluates the clinical outcomes of C+CRT compared to CRT alone or adjuvant chemotherapy alone (C) for resected pancreatic cancer. Methods: The NCDB was queried for primary stage I-II, cT1-3N0-1M0, resected pancreatic adenocarcinoma treated with adjuvant C, CRT, or C+CRT (2004-2015). Patients treated with C+CRT were compared with those treated with C (cohort C) or with CRT (cohort CRT). The primary endpoint was overall survival (OS). Baseline patient, tumor, and treatment characteristics were examined. Kaplan-Meier analysis, multivariable Cox proportional hazards method, forest plot, and propensity score matching were used. Results: Among 5667 patients (n = 3031 for C, n = 1307 for CRT, n = 1329 for C+CRT), median follow-up was 34.7 months, 45.2 months, and 39.7 months for the C, CRT, and C+CRT cohorts, respectively. In the multivariable analysis for all patients, C (HR 1.31, p < 0.001) and CRT (HR 1.24, p < 0.001) were associated with worse mortality compared to C+CRT. Treatment interactions were seen among pathologically node positive disease. C+CRT was favored in 1-3 (HR 0.74, p < 0.001) and 4+ (HR 0.75, p < 0.001) positive lymph node disease when compared to C or CRT alone, but none of the treatment options were significantly favored in node negative disease (HR 0.96, p = 0.67). Using 1:1 propensity score matching, 2152 patients for cohort C and 1774 patients for cohort CRT were matched. C+CRT remained significant for improved OS for both cohort C (median OS 23.3 vs 20.0 months, p < 0.001) and cohort CRT (median OS 23.4 vs 20.8 months, p < 0.001). Conclusions: This NCDB study using propensity score matched analysis demonstrates an OS benefit for C+CRT compared to C or CRT alone following surgical resection of pancreatic cancer. Most of this benefit is in patients with positive lymph nodes.

scholarly journals Recurrence and Survival Outcomes After Anatomic Segmentectomy Versus Lobectomy for Clinical Stage I Non–Small-Cell Lung Cancer: A Propensity-Matched Analysis

2014 ◽  
Vol 32 (23) ◽  
pp. 2449-2455 ◽  
Author(s):  
Rodney J. Landreneau ◽  
Daniel P. Normolle ◽  
Neil A. Christie ◽  
Omar Awais ◽  
Joseph J. Wizorek ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Propensity Score Matching ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Hazard Ratio ◽  
Stage I ◽  
Small Cell Lung

PurposeAlthough anatomic segmentectomy has been considered a compromised procedure by many surgeons, recent retrospective, single-institution series have demonstrated tumor recurrence and patient survival rates that approximate those achieved by lobectomy. The primary objective of this study was to use propensity score matching to compare outcomes after these anatomic resection approaches for stage I non–small-cell lung cancer.Patients and MethodsA retrospective data set including 392 segmentectomy patients and 800 lobectomy patients was used to identify matched segmentectomy and lobectomy cohorts (n = 312 patients per group) using a propensity score matching algorithm that accounted for confounding effects of preoperative patient variables. Primary outcome variables included freedom from recurrence and overall survival. Factors affecting survival were assessed by Cox regression analysis and Kaplan-Meier estimates.ResultsPerioperative mortality was 1.2% in the segmentectomy group and 2.5% in the lobectomy group (P = .38). At a mean follow-up of 5.4 years, comparing segmentectomy with lobectomy, no differences were noted in locoregional (5.5% v 5.1%, respectively; P = 1.00), distant (14.8% v 11.6%, respectively; P = .29), or overall recurrence rates (20.2% v 16.7%, respectively; P = .30). Furthermore, when comparing segmentectomy with lobectomy, no significant differences were noted in 5-year freedom from recurrence (70% v 71%, respectively; P = .467) or 5-year survival (54% v 60%, respectively; P = .258). Segmentectomy was not found to be an independent predictor of recurrence (hazard ratio, 1.11; 95% CI, 0.87 to 1.40) or overall survival (hazard ratio, 1.17; 95% CI, 0.89 to 1.52).ConclusionIn this large propensity-matched comparison, lobectomy was associated with modestly increased freedom from recurrence and overall survival, but the differences were not statistically significant. These results will need further validation by prospective, randomized trials (eg, Cancer and Leukemia Group B 140503 trial).

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