scholarly journals Introduction of a New Pathology Workup Protocol for Glottic Cancer Treated With Transoral Laser Microsurgery (TLM): Prospective Analysis of Oncological Outcomes and Matched Case-Control Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Jeroen Meulemans ◽  
Sara Narimani ◽  
Esther Hauben ◽  
Sandra Nuyts ◽  
Annouschka Laenen ◽  
...  
Keyword(s):  
Case Control ◽  
Margin Status ◽  
Glottic Cancer ◽  
P Value ◽  
Control Analysis ◽  
Prognostic Effect ◽  
Oncological Outcomes ◽  
Deep Margin ◽  
Matched Case ◽  
Case Control Analysis

Background/PurposeThe value of margin status after TLM for glottic cancer is debatable, due to difficulties in specimen orientation and margin analysis. To reduce these difficulties, we recently introduced a standardized protocol of oriented fixation of TLM specimens. This proved feasible and resulted in high margin evaluability rates and a decreased rate of false positive deep margins, when compared to a historical TLM cohort. For the patients whose specimens were processed according to this protocol, we prospectively analyzed oncological outcomes, identified prognostic factors and assessed the influence of the protocol introduction on outcomes compared with a historical TLM cohort.MethodsNinety-six patients with glottic malignancies treated with TLM were included. Resection specimens were processed according to the new protocol. Descriptive statistics and survival analyses were used to determine oncological outcomes. To assess the effect of the protocol introduction on outcomes, a matched-case-control analysis was performed, using a historical TLM-cohort as controls. The Cox proportional hazards model was used to analyze prognostic effects of patient and treatment characteristics, including the pathology protocol introduction, on overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS) and local recurrence-free survival (LRFS).ResultsTwo-year outcomes were favorable: 88.5% OS, 97.0% DSS, and 87.6% LRFS. At multivariable analysis, the presence of multiple positive superficial margins was a negative prognosticator for OS (HR 4.102) and increasing cT classification proved a negative prognosticator for DFS (HR 2.828) and LRFS (HR 2.676). Matched case-control analysis did not reveal a significant difference in oncological outcomes between cohorts. Deep margin status had a strong differential effect for DFS (p-value for interaction = 0.0205) and for LRFS (p-value for interaction = 0.0176) between cohorts, indicating a prognostic effect of deep margin status on both outcomes in the current cohort, but not in the historical cohort.Discussion/ConclusionThe introduction of a new standardized technique of oriented fixation of TLM specimens did not affect oncological outcomes when compared to a historical TLM cohort, but assigned a significant prognostic effect to deep margin status for DFS and LRFS, facilitating the decision making process with regards to planning of second-look procedures, administration of adjuvant radiotherapy or determination of follow-up intensity.

Influence of Prognostic Risk Indicators on Osseointegrated Dental Implant Failure: A Matched Case-Control Analysis

2012 ◽  
Vol 38 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Rami Alissa ◽  
Richard J. Oliver
Keyword(s):  
Dental Implant ◽  
Case Control ◽  
Implant Failure ◽  
Risk Indicators ◽  
Therapeutic Modality ◽  
Control Analysis ◽  
Wide Diameter ◽  
Related Risk ◽  
Matched Case ◽  
Case Control Analysis

Dental implant treatment is an important therapeutic modality with documented long-term success for replacement of missing teeth. However, dental implants can be susceptible to disease conditions or healing complications that may lead to implant loss. This case-control study identified several risk indicators associated with failure such as smoking and alcohol consumption. The use of postoperative antibiotics or wide-diameter implants may significantly reduce implant failure. Knowledge of patient-related risk factors may assist the clinician in proper case selection and treatment planning.

scholarly journals Life-threatening alcohol-related traffic crashes in adverse weather: a double-matched case–control analysis from Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e024415 ◽  
Author(s):  
Donald A Redelmeier ◽  
Fizza Manzoor
Keyword(s):  
Relative Risk ◽  
Case Control ◽  
Additional Patient ◽  
Control Analysis ◽  
Drinking And Driving ◽  
Traffic Crash ◽  
Adverse Weather ◽  
Life Threatening ◽  
Matched Case ◽  
Case Control Analysis

ImportanceDrunk driving is a major cause of death in North America, yet physicians rarely counsel patients on the risks of drinking and driving.ObjectiveTo test whether the risks of a life-threatening alcohol-related traffic crash were further accentuated by adverse weather.DesignDouble matched case–control analysis of hospitalised patients.SettingCanada’s largest trauma centre between 1 January 1995 and 1 January 2015.ParticipantsPatients hospitalised due to a life-threatening alcohol-related traffic crash.ExposureRelative risk of a crash associated with adverse weather estimated by evaluating the weather at the place and time of the crash (cases) compared with the weather at the same place and time a week earlier and a week later (controls).ResultsA total of 2088 patients were included, of whom the majority were drivers injured at night. Adverse weather prevailed among 312 alcohol-related crashes and was significantly more frequent compared with control circumstances. The relative risk of a life-threatening alcohol-related traffic crash was 19% higher during adverse weather compared with normal weather (95% CI: 5 to 35, p=0.006). The absolute increase in risk amounted to 43 additional crashes, extended to diverse groups of patients, applied during night-time and daytime, contributed to about 793 additional patient-days in hospital and was distinct from the risks for drivers who were negative for alcohol.ConclusionsAdverse weather was associated with an increased risk of a life-threatening alcohol-related traffic crash. An awareness of this risk might inform warnings to patients about traffic safety and counselling alternatives to drinking and driving.

Morbidity of Staged Proctectomy After Hepatectomy for Colorectal Cancer: A Matched Case–Control Analysis

2012 ◽  
Vol 20 (2) ◽  
pp. 482-490 ◽  
Author(s):  
Ching-Wei D. Tzeng ◽  
Thomas A. Aloia ◽  
Jean-Nicolas Vauthey ◽  
George J. Chang ◽  
Lee M. Ellis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Case Control ◽  
Control Analysis ◽  
Matched Case ◽  
Case Control Analysis

Does Partial Cystectomy Compromise Oncologic Outcomes for Patients with Bladder Cancer Compared to Radical Cystectomy? A Matched Case-Control Analysis

2012 ◽  
Vol 188 (4) ◽  
pp. 1115-1119 ◽  
Author(s):  
John J. Knoedler ◽  
Stephen A. Boorjian ◽  
Simon P. Kim ◽  
Christopher J. Weight ◽  
Prabin Thapa ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Case Control ◽  
Partial Cystectomy ◽  
Oncologic Outcomes ◽  
Control Analysis ◽  
Matched Case ◽  
Case Control Analysis

Postmastectomy Radiation and Mortality in Women With T1-2 Node-Positive Breast Cancer

2005 ◽  
Vol 23 (7) ◽  
pp. 1409-1419 ◽  
Author(s):  
Benjamin D. Smith ◽  
Grace L. Smith ◽  
Bruce G. Haffty
Keyword(s):  
Breast Cancer ◽  
Case Control ◽  
Control Analysis ◽  
Regional Lymph Nodes ◽  
Node Positive ◽  
Specific Mortality ◽  
Matched Case ◽  
Case Control Analysis ◽  
The Relationship ◽  
Positive Breast Cancer

Purpose To determine the relationship between postmastectomy radiotherapy (PMRT) and mortality in a population-based cohort of women with T1-2 node-positive breast cancer. Patients and Methods Using data from the Surveillance, Epidemiology, and End Results program, we identified 18,038 women with T1-2 node-positive invasive breast cancer who were treated with mastectomy between 1988 and 1995. The relationship between PMRT and mortality was determined using proportional hazards multivariate modeling and propensity score matched case-control analysis. Results Median follow-up was 8.1 years. Only 2,648 women (15%) received PMRT. After adjusting for covariates, PMRT use was not associated with mortality (hazard ratio [HR] = 0.96; 95% CI, 0.90 to 1.03). However, the interaction term for PMRT use and number of involved regional lymph nodes was significant (P = .002), suggesting that, above a certain threshold of involved nodes, a mortality benefit from PMRT may exist. Adjusted analysis stratified by number of involved nodes revealed that patients with seven or more involved nodes treated with PMRT experienced a significant reduction in all-cause (HR = 0.84; 95% CI, 0.76 to 0.93) and cause-specific mortality (HR = 0.86; 95% CI, 0.77 to 0.96). Propensity score matched case-control analysis confirmed that PMRT was associated with reduced mortality only in the subset of patients with seven or more involved nodes (HR = 0.81; 95% CI, 0.73 to 0.91 for all-cause mortality; and HR = 0.82; 95% CI, 0.72 to 0.93 for cause-specific mortality). Conclusion For women with T1-2 breast cancer, PMRT is associated with a 15% to 20% relative reduction in mortality for patients with seven or more involved regional lymph nodes.

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