scholarly journals The Role of Adjuvant Chemotherapy in Metaplastic Breast Carcinoma: A Competing Risk Analysis of the SEER Database

2021 ◽  
Vol 11 ◽  
Author(s):  
Tian Lan ◽  
Yunyan Lu ◽  
Ruzhen Zheng ◽  
Xiying Shao ◽  
Hua Luo ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Risk Analysis ◽  
Selection Process ◽  
Treatment Strategies ◽  
Competing Risk ◽  
Lymph Node Status ◽  
Seer Database ◽  
Competing Risk Analysis ◽  
Metaplastic Breast Carcinoma

Purpose: Chemotherapy is the clinically recommended treatment for patients with operable metaplastic breast carcinoma (MBC); however, its impact remains controversial. This study investigated the possible role of chemotherapy in the treatment of MBC.Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify the operable MBC patients. The competing risk analysis along with the propensity score matching (PSM) method was performed to evaluate the effect of chemotherapy. Moreover, a competing risk nomogram was built to identify prognosis in patients with MBC.Results: Of the 1137 patients with MBC, 775 received chemotherapy and 362 did not receive chemotherapy. The 5-year cumulative incidence of breast cancer-specific death (BCSD) showed similar outcomes in both the Chemo and No-Chemo groups (21.1 vs. 24.3%, p = 0.57). Chemotherapy showed no apparent association with BCSD (HR, 1.07; 95% CI, 0.72–1.60; p = 0.72), even after subgroup analysis or PSM. Race, tumor size, lymph node status, and radiation were identified as the significant factors for MBC after a penalized variable selection process. In addition, a competing risk nomogram showed relatively good accuracy of prediction with a C-index of 0.766 (95% CI, 0.700–0.824).Conclusion: Our findings demonstrated that chemotherapy did not improve BCSD for operable MBC patients. Thus, it may indicate the need to reduce exposure to the current chemotherapy strategies for patients with resectable MBC. Additionally, some novel treatment strategies are required urgently to identify and target the potential biomarkers.

scholarly journals A Scoring System For Predicting Hepatocellular Carcinoma Risk In Alcoholic Cirrhosis: A Competing Risk Analysis

2021 ◽  
Author(s):  
Kyunghan Lee ◽  
Gwang Hyeon Choi ◽  
Eun Sun Jang ◽  
Sook-Hyang Jeong ◽  
Jin–Wook Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Analysis ◽  
Viral Hepatitis ◽  
Validation Cohort ◽  
Alcoholic Cirrhosis ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Hazards Model ◽  
B Virus

Abstract Background & Aims: The role of hepatocellular carcinoma (HCC) surveillance is being questioned in alcoholic cirrhosis because of the relative low HCC risk. Comorbid viral hepatitis may synergistically increase the HCC risk in alcoholic cirrhosis. This study aimed to assess the risk and predictors of HCC in patients with alcoholic cirrhosis by using competing risk analysis in an area with intermediate prevalence for hepatitis B virus.Methods: A total of 965 patients with alcoholic cirrhosis were recruited at a university-affiliated hospital in Korea and randomly assigned to either the derivation (n=643) and validation (n=322) cohort. Subdistribution hazards model of Fine and Gray was used with deaths and liver transplantation treated as competing risks. Death records were confirmed from Korean government databases. A nomogram was developed to calculate the Alcohol-associated Liver Cancer Estimation (ALICE) score.Results: Markers for viral hepatitis were positive in 21.0 % and 25.8 % of patients in derivation and validation cohort, respectively. The cumulative incidence of HCC was 13.5 and 14.9 % at 10 years for derivation and validation cohort, respectively. Age, positivity for viral hepatitis markers, alpha-fetoprotein level, and platelet count were identified as independent predictors of HCC and incorporated in the ALICE score, which discriminated low, intermediate, and high risk for HCC in alcoholic cirrhosis at the cut-off of 120 and 180. Conclusions: HCC risk can be stratified by using clinical parameters including viral markers in alcoholic cirrhosis in an area where the prevalence of viral hepatitis is substantial.

scholarly journals Competing risk analysis of primary tracheal carcinoma based on SEER database

2019 ◽  
Vol Volume 11 ◽  
pp. 1059-1065
Author(s):  
HongXiang Gao ◽  
Xuan He ◽  
JianFei Du ◽  
SanHu Yang ◽  
Yang Wang ◽  
...  
Keyword(s):  
Risk Analysis ◽  
Competing Risk ◽  
Seer Database ◽  
Competing Risk Analysis

scholarly journals Research on the Role of Combined Chemotherapy and Radiotherapy in Patients With N+ Non-Metastatic Metaplastic Breast Carcinoma: A Competing Risk Analysis Model Based on the SEER database, 2000 to 2015

2021 ◽  
Vol 10 ◽  
Author(s):  
Yifei Ma ◽  
Zejian Yang ◽  
Yihan Gao ◽  
Kunlong Li ◽  
Pei Qiu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Therapy Group ◽  
Model Analysis ◽  
Competing Risk ◽  
Mode Analysis ◽  
Combined Chemotherapy ◽  
Risk Of Death ◽  
Metaplastic Breast Carcinoma

PurposeDue to the rarity of metaplastic breast carcinoma (MpBC), no randomized trials have investigated the role of combined chemotherapy and radiotherapy (CCRP) in this condition. We aimed to explore and identify the effectiveness of CCRP in patients with regional lymph node metastasis (N+) non-metastatic MpBC.Materials and MethodsData were obtained from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program database. We assessed the effects of CCRP on overall survival (OS), breast cancer-specific survival (BCSS), and breast cancer-specific death (BCSD) using Kaplan-Meier analysis, competing risk model analysis, and competing risk regression mode analysis.ResultsA total of 707 women and 361 death cases were included in the unmatched cohort, of which 76.45% (276/361) were BCSD, and 23.55% (85/361) were non-breast cancer-specific deaths (non-BCSD). Both the ChemT and CCRP groups had better OS (ChemT group: HR: 0.59, 95% CI: 0.45–0.78, P<0.001; CCRP group: HR: 0.31, 95% CI: 0.23–0.41, P<0.001) and BCSS (ChemT group: HR: 0.63, 95% CI: 0.45–0.87, P<0.001; CCRP group: HR: 0.32, 95%CI: 0.22–0.46, P<0.001) than the non-therapy group. Subjects in the CCRP group tended to have significantly lower cumulative BCSD (Gray’s test, P=0.001) and non-BCSD (Gray’s test, P<0.001) than the non-therapy group or ChemT group. In competing risk regression model analysis, subjects in the CCRP group had a better prognosis in BCSD (HR: 0.710, 95% CI: 0.508–0.993, P=0.045) rather than the ChemT group (HR: 1.081, 95% CI: 0.761–1.535, P=0.660) than the non-therapy group.ConclusionOur study demonstrated that CCRP could significantly decrease the risk of death for both BCSD and non-BCSD and provided a valid therapeutic strategy for patients with N+ non-metastatic MpBC.

scholarly journals Competing Risk Analysis of Cardiovascular/Cerebrovascular Death in T1/2 Kidney Cancer: A SEER Database Analysis

2020 ◽  
Author(s):  
Xiaofei Mo ◽  
Mingge Zhou ◽  
Hui Yan ◽  
Xueqin Chen ◽  
Yuetao Wang
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Risk Analysis ◽  
Kidney Cancer ◽  
Tumor Size ◽  
Primary Site ◽  
Competing Risk ◽  
Seer Database ◽  
Competing Risk Analysis ◽  
N Status

Abstract Background: Kidney cancer (KC) is associated with cardiovascular regulation disorder, which easily leads to cardiovascular and cerebrovascular death (CCD), and CCD is one of the major causes of death in patients with KC, especially in T1/2 status. However, there are few studies treated CCD as an independent outcome and analyzed the risk factors related to this outcome. We aimed to evaluate the key factors associated with CCD or kidney cancer-specific death (KCD) in patients with T1/2 KC by competing risk analysis, and compared these two kinds of risk factors to offer some information for clinical management. Methods: A total of 45117 patients diagnosed with first primary KC in T1/2 status between 2004-2015 were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. According to their outcomes at the end of follow-up, all patients were divided into CCD group (n=3087), KCD group (n=3212), Other Events group (n=6312) and Alive group (n=32506). Patients’ clinical characteristics were estimated their association with CCD and KCD by Fine-Gray’s competing risk model. Factors significantly correlating with CCD or KCD were used to create forest plots to compare their differences.Results: The Fine-Gray’s competing risk analysis showed that age at diagnosis, race, marital status, tumor size, AJCC T stage, chemotherapy, kind of surgery of primary site and scope of lymph node were correlated significantly with CCD. Moreover, age at diagnosis, sex, marital status, tumor size, AJCC T/N status, radiation therapy, chemotherapy, kind of surgery of primary site and scope of lymph node were correlated significantly with KCD. Then the forest plots of these two kinds factors were established to compare their difference. It was found that age at diagnose, race, AJCC T/N status and therapy methods represented significantly different risks for patients with T1/2 KC developing to CCD or KCD.Conclusion: We firstly separated CCD and KCD as two independent outcomes to analysis the risk factors related them, and found that age at diagnose, race, AJCC T/N status and therapy methods differently affected patients with T1/2 KC developing to CCD or KCD.

scholarly journals A Novel Competing Risk Analysis Model to Determine the Role of Cervical Lordosis in Bony and Ligamentous Injuries

2018 ◽  
Vol 119 ◽  
pp. e962-e967
Author(s):  
Narayan Yoganandan ◽  
Anjishnu Banerjee ◽  
Nicholas DeVogel ◽  
Frank A. Pintar ◽  
Jamie L. Baisden
Keyword(s):  
Risk Analysis ◽  
Competing Risk ◽  
Cervical Lordosis ◽  
Competing Risk Analysis ◽  
Analysis Model

scholarly journals The role of chemotherapy in patients with T1bN0M0 triple-negative breast cancer: a real-world competing risk analysis

2021 ◽  
Vol 12 (1) ◽  
pp. 10-17
Author(s):  
Tian Lan ◽  
Yunyan Lu ◽  
Hua Luo ◽  
Ouou Yang ◽  
Junling He ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Analysis ◽  
Triple Negative Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Competing Risk ◽  
Competing Risk Analysis

The prognostic role of body mass index on mortality amongst the middle-aged and elderly: A competing risk analysis

2014 ◽  
Vol 103 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Haleh Ghaem Maralani ◽  
Bee Choo Tai ◽  
Tien Y. Wong ◽  
E. Shyong Tai ◽  
Jialiang Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Risk Analysis ◽  
Body Mass ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Prognostic Role ◽  
Middle Aged

scholarly journals Competing risk analysis of cardiovascular/cerebrovascular death in T1/2 kidney cancer: a SEER database analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaofei Mo ◽  
Mingge Zhou ◽  
Hui Yan ◽  
Xueqin Chen ◽  
Yuetao Wang
Keyword(s):  
Risk Factors ◽  
Radiation Therapy ◽  
Risk Analysis ◽  
Kidney Cancer ◽  
Competing Risk ◽  
Age At Diagnosis ◽  
Seer Database ◽  
Competing Risk Analysis ◽  
Factors Associated ◽  
N Status

Abstract Background Kidney cancer (KC) is associated with cardiovascular regulation disorder and easily leads to cardiovascular and cerebrovascular death (CCD), which is one of the major causes of death in patients with KC, especially those with T1/2 status. However, few studies have treated CCD as an independent outcome for analysis. We aimed to identify and evaluate the key factors associated with CCD in patients with T1/2 KC by competing risk analysis and compared these risk factors with those associated with kidney cancer-specific death (KCD) to offer some information for clinical management. Methods A total of 45,117 patients diagnosed with first primary KC in T1/2 status were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were divided into the CCD group (n = 3087), KCD group (n = 3212), other events group (n = 6312) or alive group (n = 32,506). Patients’ characteristics were estimated for their association with CCD or KCD by a competing risk model. Pearson’s correlation coefficient and variance inflation factor (VIF) were used to detect collinearity between variables. Factors significantly correlated with CCD or KCD were used to create forest plots to compare their differences. Results The competing risk analysis showed that age at diagnosis, race, AJCC T/N status, radiation therapy, chemotherapy and scope of lymph node represented different relationships to CCD than to KCD. In detail, age at diagnosis (over 74/1–50: HR = 9.525, 95% CI: 8.049–11.273), race (white/black: HR = 1.475, 95% CI: 1.334–1.632), AJCC T status (T2/T1: HR = 0.847, 95% CI: 0.758–0.946) and chemotherapy (received/unreceived: HR = 0.574, 95% CI: 0.347–0.949) were correlated significantly with CCD; age at diagnosis (over 74/1–50: HR = 3.205, 95% CI: 2.814–3.650), AJCC T/N status (T2/T1: HR = 2.259, 95% CI: 2.081–2.451 and N1/N0:HR = 3.347, 95% CI: 2.698–4.152), radiation therapy (received/unreceived: HR = 2.552, 95% CI: 1.946–3.346), chemotherapy (received/unreceived: HR = 2.896, 95% CI: 2.342–3.581) and scope of lymph nodes (1–3 regional lymph nodes removed/none: HR = 1.378, 95% CI: 1.206–1.575) were correlated significantly with KCD. Conclusions We found that age at diagnosis, race, AJCC T status and chemotherapy as the independent risk factors associated with CCD were different from those associated with KCD.

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