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

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 < 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.

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

10.21203/rs.3.rs-821003/v1 ◽

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.

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Efficacy of Chemotherapy in Survival of Stage I Nasopharyngeal Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.735817 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jia-Lin Ma ◽

Shi-Ting Huang ◽

Yan-Ming Jiang ◽

Xin-Bin Pan

Keyword(s):

Overall Survival ◽

Nasopharyngeal Carcinoma ◽

Multivariate Regression ◽

Multivariate Regression Analysis ◽

Stage I ◽

Cancer Specific Survival ◽

Radiotherapy Group ◽

Kaplan Meier ◽

Before And After ◽

Radiotherapy Alone

PurposeTo identify whether chemoradiotherapy improves survival of stage I nasopharyngeal carcinoma (NPC).Materials and MethodsNPC patients were extracted from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. Pathologically confirmed stage T1N0M0 (the 7th edition AJCC) were investigated. Overall survival (OS) and cancer-specific survival (CSS) were compared between the radiotherapy and chemoradiotherapy groups using the Kaplan-Meier method and propensity score matching (PSM) analyses.ResultsThis study included 91 (40.27%) patients in the chemoradiotherapy group and 135 (59.73%) patients in the radiotherapy group. Before PSM, chemoradiotherapy was associated with worse 3-year OS (74.31 vs 87.23%; P = 0.025) and 5-year OS (64.28 vs 83.12%; P = 0.001) compared to those associated with radiotherapy. Similarly, chemoradiotherapy showed worse 3-year CSS (87.01 vs 96.97%; P = 0.028) and 5-year CSS (80.39 vs. 96.97%; P = 0.002) than those of radiotherapy. After PSM, chemoradiotherapy revealed worse 5-year OS (63.10 vs. 82.49%; P = 0.031) and CSS (80.95 vs. 93.70%; P = 0.016) than radiotherapy. The multivariate regression analysis revealed that chemoradiotherapy was an independent risk prognostic factor for OS and CSS before and after PSM.ConclusionRadiotherapy alone is recommended for stage I NPC patients.

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

BMC Cancer ◽

10.1186/s12885-021-08802-8 ◽

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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The Role of Radiotherapy in Soft Tissue Sarcoma on Extremities With Lymph Nodes Metastasis: An IPTW Propensity Score Analysis of the SEER Database

Frontiers in Oncology ◽

10.3389/fonc.2021.751180 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xinzhu Qiu ◽

Hongbo He ◽

Hao Zeng ◽

Xiaopeng Tong ◽

Qing Liu

Keyword(s):

Soft Tissue ◽

Propensity Score ◽

Lymph Nodes ◽

Cox Regression ◽

Rank Test ◽

Seer Database ◽

Cox Regression Analysis ◽

Lymph Nodes Metastasis ◽

Log Rank Test ◽

Kaplan Meier

BackgroundSoft tissue sarcomas on extremities with regional lymph nodes metastasis (STSE-RLNM) is a devastating situation. Optimizing therapeutic approaches is vital but hampered by a shortage of randomized trials. We used a population-level database to evaluate radiotherapy’s impact on sarcoma-specific survival (SSS) and overall survival (OS) for surgery for STSE-RLNM.MethodsWe retrospectively screened data from the SEER database (2004–2015), and 265 patients with STSE-RLNM who received surgery, with (134) or without (131) radiotherapy, were enrolled in this study. A propensity-score-matched analysis with the inverse probability of treatment weighting (IPTW) Kaplan–Meier curve was created. The log-rank test and Cox regression analysis were performed to compare SSS and OS in patients with and without radiotherapy. Further analysis of radiotherapy time was conducted, and the Kaplan–Meier curve and the log-rank test were done. Landmark analysis was introduced to attenuate the immortal bias.ResultsIn the original unadjusted cohort, the radiotherapy + surgery group is associated with improved SSS [hazard ratio (HR), 0.66; 95% CI, 0.47–0.91; p = 0.011] and OS (HR, 0.64; 95% CI, 0.47–0.88; p = 0.006). This significant treatment effect was also noted in IPTW-adjusted Cox regression either on SSS (HR, 0.65; 95% CI, 0.45–0.93; p = 0.020) or on OS (HR, 0.64; 95% CI, 0.46–0.91; p = 0.013). The Kaplan–Meier curve and log-rank test showed that pre- and postoperative radiotherapy was not related to SSS (p = 0.980 or OS (p = 0.890).ConclusionRadiotherapy and surgery has a significant benefit on the prognosis of patients with STSE-RLNM compared to surgery alone. These findings should be considered when making treatment decisions for them.

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Effect Of Prior Cancer History on The Survival of Gallbladder Cancer Patients: A Propensity Score Matching Study Based on The SEER Database

10.21203/rs.3.rs-115865/v1 ◽

2020 ◽

Author(s):

Jie Ren ◽

Wei Liu ◽

Qinglin Li ◽

Ruixia Cui ◽

Yingmu Tong ◽

...

Keyword(s):

Propensity Score ◽

Gallbladder Cancer ◽

Propensity Score Matching ◽

Cancer Patients ◽

The United States ◽

Primary Cancer ◽

Seer Database ◽

Primary Malignancy ◽

Kaplan Meier ◽

The Impact

Abstract Background: The effect of previous malignancy history on the survival of individuals with a second primary gallbladder cancer remains unclear. Therefore, this study was conducted to analyze the impact of previous malignancy history on the survival of individuals with gallbladder cancer and to compare the prognostic differences between gallbladder cancer patients with and without previous cancer.Methods: Extract the United States Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 for cases diagnosed with gallbladder cancer. The Kaplan-Meier curves and log-rank test were used to compare the survival difference between gallbladder cancer individuals with and without previous malignancy. Cox proportional hazards regression model was used to explore the risk factors of gallbladder cancer.Results: A total of 5861 patients with gallbladder cancer were enrolled, including 5622 (95.9%) patients without prior primary cancer and 239 (4.1%) patients with prior primary cancer. Patients with gallbladder cancer with prior primary malignancy were older, and the tumors were at localized and regional stages more frequently and more early stages. The Kaplan-Meier curves showed that gallbladder cancer patients with prior cancer had better overall survival (OS) (P=0.027) and gallbladder cancer-specific survival (GCSS) (P<0.001) before propensity score matching (PSM), and gallbladder cancer patients with prior cancer had better GCSS (P<0.001), and there was no difference in OS (P=0.113) between gallbladder cancer patients with and without prior cancer after PSM. Multivariable cox regression analysis revealed that prior malignancy history was not a risk factor for OS (HR=0.875, 95%CI: 0.752-1.018, P=0.084), but it was beneficial to GCSS (HR=0.404, 95%CI: 0.318-0.513, P<0.001).Conclusions: Gallbladder cancer individuals with previous primary malignancy have different clinical characteristics from those without previous primary malignancy. Gallbladder cancer patients with previous primary malignancy have better progress than those without previous malignancy.

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The Effect of Marital Status on Survival of Patients with Gastrointestinal Stromal Tumors: A SEER Database Analysis

Gastroenterology Research and Practice ◽

10.1155/2018/5740823 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Wei Song ◽

Chuan Tian

Keyword(s):

Prognostic Factor ◽

Marital Status ◽

Gastrointestinal Stromal Tumors ◽

Cox Regression ◽

Seer Database ◽

Cancer Specific Survival ◽

Stromal Tumors ◽

Kaplan Meier ◽

Risk Of Cancer ◽

The Impact

Background. Marital status has been reported to be a prognostic factor in multiple malignancies. However, its prognostic value on gastrointestinal stromal tumors (GISTs) have not yet been determined. The objective of the present analysis was to assess the effects of marital status on survival in patients with GISTs. Methods. The Surveillance, Epidemiology, and End Results (SEER) database was used to analyze 6195 patients who were diagnosed with GISTs from 2001 to 2014. We also use Kaplan-Meier analysis and Cox regression to analyze the impact of marital status on cancer-specific survival (CSS). Results. Patients in the married group had more frequency in white people, more high/moderate grade tumors, and were more likely to receive surgery. Widowed patients had a higher proportion of women, a greater proportion of older patients (>60 years), and more common site of the stomach. Multivariate analysis demonstrated that marital status was an independent prognostic factor for GISTs (P<0.001). Married patients had better CSS than unmarried patients (P<0.001). Subgroup analysis suggested that widowed patients had the lowest CSS compared with all other patients. Conclusions. Marital status is a prognostic factor for survival in patients with GISTs, and widowed patients are at greater risk of cancer-specific mortality.

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Impact of morphine use on mortality in STEMI patients treated with primary PCI - preliminary data from a new registry

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.090 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

D Szabo ◽

A Szabo ◽

IF Edes ◽

D Becker ◽

B Merkely ◽

...

Keyword(s):

Propensity Score ◽

Propensity Score Matching ◽

Survival Data ◽

Preliminary Data ◽

Laboratory Data ◽

Rank Test ◽

Primary Pci ◽

Kaplan Meier ◽

P2y12 Antagonists ◽

Current Guidelines

Abstract Funding Acknowledgements Type of funding sources: None. Background Opioids decrease the effect of P2Y12 receptor inhibitors in vitro and observational reports suggest that morphine use is associated with larger infarct size. Our research group presented previously, using a prospective single-center registry, that periprocedural morphine use may have no impact on long-term mortality in STEMI patients treated with primary PCI and clopidogrel. Purpose Our purpose is to check this interaction using a new registry of patients treated according to the current guidelines, including novel antiplatelet agents. Methods From May until November 2020, we collected 196 STEMI patients treated with primary PCI. 88 (44.9%) of them got morphine during the prehospital and periprocedural care. Baseline demographic, anamnestic, procedural, and laboratory data were collected. Survival data were analysed using Kaplan-Meier survival curves and the log-rank test. To adjust for confounding, a 1:1 propensity score-matching analysis was performed using 114 cases. Results An adequate balance on baseline covariates was achieved during propensity score-matching. Kaplan-Meier analysis showed no difference in 30-days mortality of the patients treated with or without morphine neither in the original nor in the propensity score-matched population (p = 0.094 and p = 0.309, respectively). Conclusion Our preliminary data suggest that morphine may have no impact on mortality in STEMI patients treated with primary PCI and medical therapy according to the current guidelines including novel P2Y12 antagonists. Abstract Figure. Kaplan-Meier curves

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Breast-Conserving Therapy is Associated with Better Survival than Mastectomy in Early-Stage Breast Cancer: A Propensity Score Analysis

10.21203/rs.3.rs-378418/v1 ◽

2021 ◽

Author(s):

Jiali Ji ◽

Shushu Yuan ◽

Jiawei He ◽

Hong Liu ◽

Lei Yang ◽

...

Keyword(s):

Breast Cancer ◽

Propensity Score ◽

Cancer Patients ◽

Propensity Score Analysis ◽

Early Stage ◽

Breast Conserving Therapy ◽

Early Stage Breast Cancer ◽

Breast Cancer Patients ◽

Kaplan Meier ◽

Score Analysis

Abstract Background: Recent retrospective studies have reported that breast-conserving therapy (BCT) led to improved overall survival (OS) than mastectomy in some populations. We aimed to compare the efficacy of BCT and mastectomy using the SEER database. Methods: Between 2010 and 2015, 99,790 eligible patients were identified. We included early-stage breast cancer patients with 5cm or smaller tumors and three or fewer positive lymph nodes in our study. We compared the OS results among patients with BCT and mastectomy. Kaplan-Meier plots, Cox proportional hazard regressions were used to evaluate the outcomes. Propensity-score matching was used to assemble a cohort of patients with similar baseline characteristics. Results: In our study, 77,452 (77.6%) patients underwent BCT and 22,338 (22.4%) underwent mastectomy. The 5-year OS rate was 94.7% in the BCT group and 87.6% in the mastectomy group (P <0.001). After matching, multivariate analysis in the matched cohort showed that women underwent mastectomy was associated with worse OS results compared with those with BCT (Hazard ratio (HR) = 1.628; 95% confidence intervals (CIs) = 1.445- 1.834, P<0.001). Patients with different subtypes and age group (>50 years old; ≤50 years old) received BCT all showed significantly better OS than those received mastectomy. The effect of surgery choice on survival was the same in matched and all cohorts. Conclusions: Our study showed that BCT was associated with improved survival compared with mastectomy in early-stage breast cancer patients. It seems advisable to encourage patients to receive BCT rather than mastectomy in early-stage patients when feasible and appropriate.

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Postmastectomy Radiotherapy in T1–2 Women Breast Cancer Patients with 1–3 Positive Axillary Lymph Nodes: A Propensity Score Matched SEER Analysis

10.21203/rs.3.rs-121109/v1 ◽

2020 ◽

Author(s):

Gang Xu ◽

Shanshan Bu ◽

Xiushen Wang ◽

Hong Ge

Keyword(s):

Breast Cancer ◽

Propensity Score ◽

Lymph Nodes ◽

Cancer Patients ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Breast Cancer Patients ◽

Cancer Specific Survival ◽

Postmastectomy Radiotherapy ◽

Positive Lymph Nodes

Abstract Purpose: The application of postmastectomy radiotherapy (PMRT) in T1–2 women breast cancer patients with 1–3 positive lymph nodes has been controversial. We sought to determine the survival benefits of PMRT in the patients with T1–2 and 1–3 positive nodes.Methods: A retrospective study using the Surveillance, Epidemiology, and End Results (SEER) Regs Custom Data (with additional treatment fields) from 2001 to 2011 was performed. Patients who received PMRT were matched by the propensity score with patients who did not receive PMRT. The Overall survival (OS) and breast cancer-specific survival (BCSS) were analyzed. Results: We identified 56,725 women breast cancer patients with T1–2 and 1–3 positive nodes, and 18,646 patients were included in the analysis. After propensity score matching (1:1), with a median follow-up of 116 months, PMRT showed an increase in the OS (P = 0.018) but had no effect on the BCSS. The 10-year OS rates were 76.8% and 74.4%, and the 10-year BCSS rates were 82.8% and 82.2% for the patients who received and who did not receive PMRT, respectively. Only patients with 3 positive nodes could gain the benefit of PMRT for BCSS.Conclusion: PMRT for patients with T1–2 and 1–3 positive lymph nodes could increase the 10-year OS, and had no effect on the 10-year BCSS. Subgroup analysis indicated that only patients with 3 positive lymph nodes could benefit from PMRT for both the OS and BCSS.

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