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[PMID]:28460061
[Au] Autor:Papaleontiou M; Hughes DT; Guo C; Banerjee M; Haymart MR
[Ad] Endereço:Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48106.
[Ti] Título:Population-Based Assessment of Complications Following Surgery for Thyroid Cancer.
[So] Source:J Clin Endocrinol Metab;102(7):2543-2551, 2017 Jul 01.
[Is] ISSN:1945-7197
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Context: As thyroid cancer incidence rises, more patients undergo thyroid surgery. Although postoperative complication rates have been reported in single institution studies, population-based data are limited. Objective: To determine thyroid cancer surgery complication rates and identify at-risk populations. Design/Setting/Patients: Using the Surveillance, Epidemiology, and End Results-Medicare database, we evaluated general complications within 30 days and thyroid surgery-specific complications within 1 year in 27,912 patients who underwent surgery for differentiated or medullary thyroid cancer between 1998 and 2011. Multivariable analyses of patient characteristics associated with postoperative complications were performed. Main Outcome Measures: General and thyroid surgery-specific complications. Results: Overall, 1820 (6.5%) patients developed general postoperative complications and 3427 (12.3%) developed thyroid surgery-specific complications. In multivariable analyses, general and thyroid surgery-specific complications were significantly higher in patients >65 years [odds ratio (OR), 2.61; 95% confidence interval (CI), 2.31 to 2.95; OR, 3.12; 95% CI, 2.85 to 3.42], those with a Charlson/Deyo comorbidity score of 1 (OR, 2.40; 95% CI, 1.66 to 3.49; OR, 1.88; 95% CI, 1.53 to 2.31) and ≥2 (OR, 7.05; 95% CI, 5.33 to 9.56; OR, 3.62; 95% CI, 3.11 to 4.25), and those with regional (OR, 1.18; 95% CI, 1.03 to 1.35; OR, 1.31; 95% CI, 1.19 to 1.45) or distant disease (OR, 2.83; 95% CI, 2.30 to 3.47; OR, 1.85; 95% CI, 1.54 to 2.21), respectively. Conclusions: The rates of thyroid cancer surgery complications are higher than predicted, and patients with older age, more comorbidities, and advanced disease are at greatest risk. Efforts to reduce complications are needed.
[Mh] Termos MeSH primário: Complicações Pós-Operatórias/epidemiologia
Neoplasias da Glândula Tireoide/patologia
Neoplasias da Glândula Tireoide/cirurgia
Tireoidectomia/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Intervalo Livre de Doença
Feminino
Seres Humanos
Incidência
Modelos Logísticos
Masculino
Medicare/estatística & dados numéricos
Meia-Idade
Análise Multivariada
Invasividade Neoplásica/patologia
Estadiamento de Neoplasias
Complicações Pós-Operatórias/fisiopatologia
Estudos Retrospectivos
Medição de Risco
Programa de SEER
Análise de Sobrevida
Neoplasias da Glândula Tireoide/mortalidade
Tireoidectomia/métodos
Estados Unidos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1210/jc.2017-00255


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[PMID]:28453693
[Au] Autor:Mahal BA; Chen YW; Muralidhar V; Mahal AR; Choueiri TK; Hoffman KE; Hu JC; Sweeney CJ; Yu JB; Feng FY; Kim SP; Beard CJ; Martin NE; Trinh QD; Nguyen PL
[Ad] Endereço:Harvard Radiation Oncology Program, Boston, USA.
[Ti] Título:Racial disparities in prostate cancer outcome among prostate-specific antigen screening eligible populations in the United States.
[So] Source:Ann Oncol;28(5):1098-1104, 2017 05 01.
[Is] ISSN:1569-8041
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background: In 2012, the United States Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA) screening, despite evidence that Black men are at a higher risk of prostate cancer-specific mortality (PCSM). We evaluated whether Black men of potentially screening-eligible age (55-69 years) are at a disproportionally high risk of poor outcomes. Patients and methods: The SEER database was used to study 390 259 men diagnosed with prostate cancer in the United States between 2004 and 2011. Multivariable logistic regression modeled the association between Black race and stage of presentation, while Fine-Gray competing risks regression modeled the association between Black race and PCSM, both as a function of screening eligibility (age 55-69 years versus not). Results: Black men were more likely to present with metastatic disease (adjusted odds ratio [AOR] 1.65; 1.58-1.72; P < 0.001) and were at a higher risk of PCSM (adjusted hazard ratio [AHR] 1.36; 1.27-1.46; P < 0.001) compared to non-Black men. There were significant interactions between race and PSA-screening eligibility such that Black patients experienced more disproportionate rates of metastatic disease (AOR 1.76; 1.65-1.87 versus 1.55; 1.47-1.65; Pinteraction < 0.001) and PCSM (AHR 1.53; 1.37-1.70 versus 1.25; 1.14-1.37; Pinteraction = 0.01) in the potentially PSA-screening eligible group than in the group not eligible for screening. Conclusions: Racial disparities in prostate cancer outcome among Black men are significantly worse in PSA-screening eligible populations. These results raise the possibility that Black men could be disproportionately impacted by recommendations to end PSA screening in the United States and suggest that Black race should be included in the updated USPSTF PSA screening guidelines.
[Mh] Termos MeSH primário: Neoplasias da Próstata/diagnóstico
[Mh] Termos MeSH secundário: Afroamericanos
Idoso
Detecção Precoce de Câncer
Disparidades em Assistência à Saúde
Seres Humanos
Calicreínas/metabolismo
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Antígeno Prostático Específico/metabolismo
Neoplasias da Próstata/metabolismo
Neoplasias da Próstata/mortalidade
Neoplasias da Próstata/terapia
Fatores de Risco
Programa de SEER
Resultado do Tratamento
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
EC 3.4.21.- (Kallikreins); EC 3.4.21.- (kallikrein-related peptidase 3, human); EC 3.4.21.77 (Prostate-Specific Antigen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/annonc/mdx041


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[PMID]:27778348
[Au] Autor:Barrington-Trimis JL; Cockburn M; Metayer C; Gauderman WJ; Wiemels J; McKean-Cowdin R
[Ad] Endereço:Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA.
[Ti] Título:Trends in childhood leukemia incidence over two decades from 1992 to 2013.
[So] Source:Int J Cancer;140(5):1000-1008, 2017 Mar 01.
[Is] ISSN:1097-0215
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Incidence rates of childhood leukemia in the United States have steadily increased over the last several decades, but only recently have disparities in the increase in incidence been recognized. In the current analysis, Surveillance, Epidemiology and End Results (SEER) data were used to evaluate recent trends in the incidence of childhood leukemia diagnosed at age 0-19 years from 1992 to 2013, overall and by age, race/ethnicity, gender and histologic subtype. Hispanic White children were more likely than non-Hispanic White, non-Hispanic Black or non-Hispanic Asian children to be diagnosed with acute lymphocytic leukemia (ALL) from 2009 to 2013. From 1992 to 2013, a significant increase in ALL incidence was observed for Hispanic White children [annual percent change (APC) = 1.08, 95% CI: 0.59, 1.58]; no significant increase was observed for non-Hispanic White, Black or Asian children. ALL incidence increased by about 3% per year from 1992 to 2013 for Hispanic White children diagnosed from 15 to 19 years (APC = 2.67; 95% CI: 0.88, 4.49) and by 2% for those 10-14 years (APC = 2.09; 95% CI: 0.57, 3.63), while no significant increases in incidence were observed in non-Hispanic White, Black, or Asian children of the same age. Acute myeloid leukemia (AML) incidence increased among non-Hispanic White children under 1 year at diagnosis, and among Hispanic White children diagnosed at age 1-4. The increase in incidence rates of childhood ALL appears to be driven by rising rates in older Hispanic children (10-14, and 15-19 years). Future studies are needed to evaluate reasons for the increase in ALL among older Hispanic children.
[Mh] Termos MeSH primário: Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Distribuição por Idade
Criança
Pré-Escolar
Grupos Étnicos/estatística & dados numéricos
Feminino
Seres Humanos
Incidência
Lactente
Recém-Nascido
Masculino
Morbidade/tendências
Leucemia-Linfoma Linfoblástico de Células Precursoras/etnologia
Estudos Retrospectivos
Programa de SEER
Estados Unidos/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1002/ijc.30487


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[PMID]:28460434
[Au] Autor:Bai DS; Chen P; Qian JJ; Jin SJ; Jiang GQ
[Ad] Endereço:Department of Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, China.
[Ti] Título:Effect of marital status on the survival of patients with gallbladder cancer treated with surgical resection: a population-based study.
[So] Source:Oncotarget;8(16):26404-26413, 2017 Apr 18.
[Is] ISSN:1949-2553
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Marital status has been reported as an independent prognostic factor for survival in various cancers, but it has been rarely studied in gallbladder cancer treated by surgical resection. We retrospectively studied Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 9,041 cases of gallbladder cancer with surgical treatment between 1988 and 2013. The patients were categorized according to marital status, as "married," "never married," "widowed," or "divorced/separated." Patients in the widowed group had a higher proportion of women within-group comparisons, a higher rate of white race, a greater proportion of older (≥ 60 years) patients, more frequency of adenocarcinoma, a greater number of tumors at well/moderate pathological grading, and more prevalence at the localized SEER stage, all of which were statistically significant (P < 0.001). Marital status was confirmed to be an independent prognostic factor by multivariate analysis (P < 0.001). Married patients had higher 5-year gallbladder cancer cause-specific survival than unmarried patients (P < 0.001); conversely, widowed patients had the lowest gallbladder cancer cause-specific survival compared with all other patients. Conclusions marital status is an important prognostic risk factor for survival in patients with gallbladder cancer treated with surgical resection. Widowed patients have the highest risk of death compared with other groups.
[Mh] Termos MeSH primário: Neoplasias da Vesícula Biliar/epidemiologia
Estado Civil
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Neoplasias da Vesícula Biliar/mortalidade
Neoplasias da Vesícula Biliar/cirurgia
Seres Humanos
Masculino
Meia-Idade
Gradação de Tumores
Estadiamento de Neoplasias
Vigilância da População
Programa de SEER
Análise de Sobrevida
Carga Tumoral
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.18632/oncotarget.15476


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[PMID]:28450031
[Au] Autor:Soneji S; Tanner NT; Silvestri GA; Lathan CS; Black W
[Ad] Endereço:Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH; Geisel School of Medicine at Dartmouth, Lebanon, NH; Norris Cotton Cancer Center, Lebanon, NH. Electronic address: samir.soneji@dartmouth.edu.
[Ti] Título:Racial and Ethnic Disparities in Early-Stage Lung Cancer Survival.
[So] Source:Chest;152(3):587-597, 2017 09.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Black patients with lung cancer diagnosed at early stages-for which surgical resection offers a potential cure-experience worse overall survival than do their white counterparts. We undertook a population-based study to estimate the racial and ethnic disparity in death from competing causes and assessed its contribution to the gap in overall survival among patients with early-stage lung cancer. METHODS: We collected survival time data for 105,121 Hispanic, non-Hispanic Asian, non-Hispanic black, and non-Hispanic white patients with early-stage (IA, IB, IIA, and IIB) lung cancer diagnosed between 2004 and 2013 from the Surveillance, Epidemiology, and End-Results registries. We modeled survival time using competing risk regression and included as covariates sex, age at diagnosis, race/ethnicity, stage at diagnosis, histologic type, type of surgical resection, and radiation sequence. RESULTS: Adjusting for demographic, clinical, and treatment characteristics, non-Hispanic blacks experienced worse overall survival compared with non-Hispanic whites (adjusted hazard ratio [aHR], 1.05; 95% CI, 1.02-1.08), whereas Hispanics and non-Hispanic Asians experienced better overall survival (aHR, 0.93; 95% CI, 0.89-0.98; and aHR, 0.82; 95% CI, 0.79-0.86, respectively). Worse survival from competing causes of death, such as cardiovascular disease and other cancers-rather than from lung cancer itself-led to the disparity in overall survival among non-Hispanic blacks (adjusted relative risk, 1.07; 95% CI, 1.02-1.12). CONCLUSIONS: Narrowing racial and ethnic disparities in survival among patients with early-stage lung cancer will rely on more than just equalizing access to surgical resection and will need to include better management and treatment of smoking-related comorbidities and diseases.
[Mh] Termos MeSH primário: Grupos Étnicos/estatística & dados numéricos
Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos
Disparidades nos Níveis de Saúde
Neoplasias Pulmonares/etnologia
Neoplasias Pulmonares/mortalidade
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Neoplasias Pulmonares/patologia
Masculino
Meia-Idade
Estadiamento de Neoplasias
Programa de SEER
Taxa de Sobrevida
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:28448665
[Au] Autor:Dasari A; Shen C; Halperin D; Zhao B; Zhou S; Xu Y; Shih T; Yao JC
[Ad] Endereço:Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston.
[Ti] Título:Trends in the Incidence, Prevalence, and Survival Outcomes in Patients With Neuroendocrine Tumors in the United States.
[So] Source:JAMA Oncol;3(10):1335-1342, 2017 Oct 01.
[Is] ISSN:2374-2445
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The incidence and prevalence of neuroendocrine tumors (NETs) are thought to be rising, but updated epidemiologic data are lacking. Objective: To explore the evolving epidemiology and investigate the effect of therapeutic advances on survival of patients with NETs. Design, Setting, and Participants: A retrospective, population-based study using nationally representative data from the Surveillance, Epidemiology, and End Results (SEER) program was conducted to evaluate 64 971 patients with NETs from 1973 to 2012. Associated population data were used to determine annual age-adjusted incidence, limited-duration prevalence, and 5-year overall survival (OS) rates. Trends in survival from 2000 to 2012 were evaluated for the entire cohort as well as specific subgroups, including distant-stage gastrointestinal NETs and pancreatic NETs. Analyses were conducted between December 2015, and February 2017. Main Outcomes and Measures: Neuroendocrine tumor incidence, prevalence, and OS rates. Results: Of the 64 971 cases of NETs, 34 233 (52.7%) were women. The age-adjusted incidence rate increased 6.4-fold from 1973 (1.09 per 100 000) to 2012 (6.98 per 100 000). This increase occurred across all sites, stages, and grades. In the SEER 18 registry grouping (2000-2012), the highest incidence rates were 1.49 per 100 000 in the lung, 3.56 per 100 000 in gastroenteropancreatic sites, and 0.84 per 100 000 in NETs with an unknown primary site. The estimated 20-year limited-duration prevalence of NETs in the United States on January 1, 2014, was 171 321. On multivariable analyses, the median 5-year OS rate varied significantly by stage, grade, age at diagnosis, primary site, and time period of diagnosis. The OS rate for all NETs improved from the 2000-2004 period to the 2009-2012 period (hazard ratio [HR], 0.79; 95% CI, 0.73-0.85). Even larger increases in OS between these periods were noted in distant-stage gastrointestinal NETs (HR, 0.71; 95% CI, 0.62-0.81) and distant-stage pancreatic NETs (HR, 0.56; 95% CI, 0.44-0.70). Conclusions and Relevance: The incidence and prevalence of NETs are steadily rising, possibly owing to detection of early-stage disease and stage migration. Survival for all NETs has improved over time, especially for distant-stage gastrointestinal NETs and pancreatic NETs in particular, reflecting improvement in therapies. These data will help to prioritize future research directions.
[Mh] Termos MeSH primário: Neoplasias Gastrointestinais/epidemiologia
Tumores Neuroendócrinos/epidemiologia
Neoplasias Pancreáticas/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Distribuição por Idade
Idoso
Feminino
Neoplasias Gastrointestinais/patologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Tumores Neuroendócrinos/patologia
Neoplasias Pancreáticas/patologia
Prevalência
Estudos Retrospectivos
Programa de SEER
Análise de Sobrevida
Taxa de Sobrevida
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoncol.2017.0589


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[PMID]:28463158
[Au] Autor:Abrams MJ; Koffer PP; Wazer DE; Hepel JT
[Ad] Endereço:Department of Radiation Oncology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts. Electronic address: mabrams@tuftsmedicalcenter.org.
[Ti] Título:Postmastectomy Radiation Therapy Is Associated With Improved Survival in Node-Positive Male Breast Cancer: A Population Analysis.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):384-391, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Because of its rarity, there are no randomized trials investigating postmastectomy radiation therapy (PMRT) in male breast cancer. This study retrospectively examines the impact of PMRT in male breast cancer patients in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. METHODS AND MATERIALS: The SEER database 8.3.2 was queried for men ages 20+ with a diagnosis of localized or regional nonmetastatic invasive ductal/lobular carcinoma from 1998 to 2013. Included patients were treated by modified radical mastectomy (MRM), with or without adjuvant external beam radiation. Univariate and multivariate analyses evaluated predictors for PMRT use after MRM. Kaplan-Meier overall survival (OS) curves of the entire cohort and a case-matched cohort were calculated and compared by the log-rank test. Cox regression was used for multivariate survival analyses. RESULTS: A total of 1933 patients were included in the unmatched cohort. There was no difference in 5-year OS between those who received PMRT and those who did not (78% vs 77%, respectively, P=.371); however, in the case-matched analysis, PMRT was associated with improved OS at 5 years (83% vs 54%, P<.001). On subset analysis of the unmatched cohort, PMRT was associated with improved OS in men with 1 to 3 positive nodes (5-year OS 79% vs 72% P=.05) and those with 4+ positive nodes (5-year OS 73% vs 53% P<.001). On multivariate analysis of the unmatched cohort, independent predictors for improved OS were use of PMRT: HR=0.551 (0.412-0.737) and estrogen receptor-positive disease: HR=0.577 (0.339-0.983). Predictors for a survival detriment were higher grade 3/4: HR=1.825 (1.105-3.015), larger tumor T2: HR=1.783 (1.357-2.342), T3/T4: HR=2.683 (1.809-3.978), higher N-stage: N1 HR=1.574 (1.184-2.091), N2/N3: HR=2.328 (1.684-3.218), black race: HR=1.689 (1.222-2.336), and older age 81+: HR=4.164 (1.497-11.582). CONCLUSIONS: There may be a survival benefit with the addition of PMRT for male breast cancer with node-positive disease.
[Mh] Termos MeSH primário: Neoplasias da Mama Masculina/mortalidade
Neoplasias da Mama Masculina/radioterapia
Carcinoma Ductal de Mama/mortalidade
Carcinoma Ductal de Mama/radioterapia
Carcinoma Lobular/mortalidade
Carcinoma Lobular/radioterapia
Linfonodos/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Análise de Variância
Neoplasias da Mama Masculina/patologia
Neoplasias da Mama Masculina/cirurgia
Carcinoma Ductal de Mama/patologia
Carcinoma Ductal de Mama/cirurgia
Carcinoma Lobular/patologia
Carcinoma Lobular/cirurgia
Terapia Combinada/métodos
Terapia Combinada/mortalidade
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Mastectomia Radical Modificada
Meia-Idade
Período Pós-Operatório
Radioterapia Adjuvante/mortalidade
Receptores Estrogênicos/análise
Receptores de Progesterona/análise
Estudos Retrospectivos
Programa de SEER
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Receptors, Estrogen); 0 (Receptors, Progesterone)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:27770556
[Au] Autor:Parikh ND; Marshall VD; Singal AG; Nathan H; Lok AS; Balkrishnan R; Shahinian V
[Ad] Endereço:Division of Gastroenterology, University of Michigan, Ann Arbor, MI.
[Ti] Título:Survival and cost-effectiveness of sorafenib therapy in advanced hepatocellular carcinoma: An analysis of the SEER-Medicare database.
[So] Source:Hepatology;65(1):122-133, 2017 01.
[Is] ISSN:1527-3350
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sorafenib is the only chemotherapeutic approved for treatment of advanced hepatocellular carcinoma (HCC). However, its effectiveness in patients with Child-Pugh class B cirrhosis and any moderating effects of health system characteristics are unclear. We examined the survival and cost-effectiveness associated with sorafenib in elderly patients with advanced HCC. We performed an analysis of Medicare beneficiaries with HCC diagnoses from 2007 to 2009. We compared advanced stage patients with HCC (American Joint Committee on Cancer stage III/IV) who received sorafenib within 6 months of diagnosis (and were otherwise untreated) to advanced stage patients with HCC who received no therapy (control). We performed univariate and multivariate analyses to identify predictors of survival. Incremental cost-effectiveness ratios (ICERs) were calculated for sorafenib-treated and control patients. We included 228 sorafenib-treated patients and 870 control patients. The median survival of the sorafenib-treated patients was 150.5 days versus 62 days for control patients. On multivariate analysis, significant predictors of improved survival were treatment with sorafenib (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.57-0.77), being seen at a National Cancer Institute-designated cancer center (HR, 0.77; 95% CI, 0.62-0.97), and being seen at a transplantation center (HR, 0.77; 95% CI, 0.65-0.93). Predictors of worse survival included stage IV disease (HR, 1.40; 95% CI, 1.24-1.58), decompensated cirrhosis (HR, 1.49; 95% CI, 1.30-1.70), and treatment in an urban setting (HR, 1.45; 95% CI, 1.21-1.73.) Although sorafenib use was associated with a survival benefit (HR, 0.61; 95% CI, 0.47-0.79) among patients with decompensated cirrhosis, the median survival benefit was 31 days, and it was not cost-effective (ICER, $224,914 per life year gained). CONCLUSION: Sorafenib is associated with improved survival in elderly patients with advanced HCC; however, it is not cost-effective among those with hepatic decompensation. (Hepatology 2017;65:122-133).
[Mh] Termos MeSH primário: Antineoplásicos/economia
Antineoplásicos/uso terapêutico
Carcinoma Hepatocelular/tratamento farmacológico
Carcinoma Hepatocelular/mortalidade
Análise Custo-Benefício
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas/mortalidade
Niacinamida/análogos & derivados
Compostos de Fenilureia/economia
Compostos de Fenilureia/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Carcinoma Hepatocelular/economia
Carcinoma Hepatocelular/patologia
Bases de Dados Factuais
Feminino
Seres Humanos
Cirrose Hepática
Neoplasias Hepáticas/economia
Neoplasias Hepáticas/patologia
Masculino
Medicare
Estadiamento de Neoplasias
Niacinamida/economia
Niacinamida/uso terapêutico
Modelos de Riscos Proporcionais
Programa de SEER
Taxa de Sobrevida
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Phenylurea Compounds); 25X51I8RD4 (Niacinamide); 9ZOQ3TZI87 (sorafenib)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180122
[Lr] Data última revisão:
180122
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE
[do] DOI:10.1002/hep.28881


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[PMID]:29217028
[Au] Autor:Andreoli MT; Chau FY; Shapiro MJ; Leiderman YI
[Ad] Endereço:Illinois Eye and Ear Infirmary, UIC Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, IL.. Electronic address: michaelandreoli@gmail.com.
[Ti] Título:Epidemiological trends in 1452 cases of retinoblastoma from the Surveillance, Epidemiology, and End Results (SEER) registry.
[So] Source:Can J Ophthalmol;52(6):592-598, 2017 Dec.
[Is] ISSN:1715-3360
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess retinoblastoma epidemiological trends in the Surveillance, Epidemiology, and End Results (SEER) registry. METHODS: All cases of retinoblastoma in the SEER database from 1973 to 2009 were identified. Kaplan-Meier survival analyses were performed for pathological grade, patient age, sex, year of diagnosis, and treatment modality. Cox proportional hazards regression assessed the impact of patient and tumour characteristics on survival. RESULTS: 1452 cases of retinoblastoma were analyzed. The mean patient age at diagnosis was 1.44 years. The tumour was unilateral in 71.0% and bilateral in 29.0%. The mean follow-up was 129.1 months. Overall survival increased during the study interval. Patients with bilateral tumours were diagnosed at an earlier age (0.46 years) than patients with unilateral disease (1.77 years; p < 0.0001). Bilateral retinoblastoma (90.3% 10-year overall survival) was associated with decreased overall survival than unilateral retinoblastoma (96.1% 10-year overall survival). Bilateral retinoblastoma was also associated with an increased incidence of nonocular malignancies (7.8%) compared with unilateral retinoblastoma (1.3%; p < 0.0001). Grade 1 tumours were diagnosed at a younger age (0.94 years) than grade 3 (2.24 years) and grade 4 tumours (2.14 years; p < 0.0001). Lower grade and lower stage tumours were independently associated with increased survival. In multivariate Cox proportional hazards analysis, T stage and laterality were the only covariates that correlated with overall survival. CONCLUSIONS: There appear to be associations between retinoblastoma tumour features such as tumour stage, pathological grade, and laterality with patient characteristics such as age at diagnosis, overall survival, and second malignancies.
[Mh] Termos MeSH primário: Sistema de Registros
Neoplasias da Retina/epidemiologia
Retinoblastoma/epidemiologia
Programa de SEER/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Pré-Escolar
Bases de Dados Factuais
Estudos Epidemiológicos
Feminino
Seres Humanos
Incidência
Lactente
Estimativa de Kaplan-Meier
Masculino
Estadiamento de Neoplasias
Neoplasias da Retina/patologia
Neoplasias da Retina/radioterapia
Retinoblastoma/patologia
Retinoblastoma/radioterapia
Taxa de Sobrevida
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE


  10 / 5688 MEDLINE  
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[PMID]:29182656
[Au] Autor:Abdel-Rahman O
[Ad] Endereço:Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
[Ti] Título:Assessment of the prognostic value of the 8th AJCC staging system for patients with clinically staged prostate cancer; A time to sub-classify stage IV?
[So] Source:PLoS One;12(11):e0188450, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The American Joint Committee on Cancer (AJCC) staging system (8th edition) for prostate cancer has been published. The current study seeks to validate the prognostic performance of the changes in the new system among clinically staged prostate cancer patients registered within the surveillance, epidemiology and end results (SEER) database. METHODS: SEER database (2004-2014) has been accessed through SEER*Stat program and AJCC 7th and 8th edition stages were calculated utilizing T, N and M stages as well as baseline prostatic specific antigen (PSA) and grade group. Cancer-specific and overall survival analyses according to 6th, 7th and 8th editions were conducted through Kaplan-Meier analysis. Moreover, multivariate analysis was conducted through a Cox proportional hazard model. RESULTS: A total of 110499 patients with prostate cancer were identified in the period from 2004-2014.For cancer- specific survival according to 8th AJCC, all pair wise P values for comparison were significant (<0.01) except for stage IIA vs. IIB; while for overall survival according to 8th AJCC, all pair wise P values for comparison were significant (<0.02) except for stage IIIA vs. IIIB. Results of c-index assessment for cancer-specific survival for the three AJCC editions were as follows: c-index for AJCC 6th edition was 0.816; c-index for AJCC 7th edition was 0.897; c-index for AJCC 8th edition was 0.907. For stage IVB prostate cancer (i.e.M1 disease), further sub-staging was proposed according to M1 sub-stage (i.e. M1a, M1b and M1c). Pair wise comparison between these proposed sub-stages was conducted for both cancer-specific and overall survival. For both cancer-specific and overall survival, all pair wise P values for comparisons were <0.0001. CONCLUSION: Compared to older staging systems (6th and 7th), the 8th system is more discriminatory. Further sub-classification of stage IV disease is suggested.
[Mh] Termos MeSH primário: Prognóstico
Neoplasias da Próstata/patologia
[Mh] Termos MeSH secundário: Idoso
Estudos de Coortes
Seres Humanos
Masculino
Neoplasias da Próstata/classificação
Neoplasias da Próstata/epidemiologia
Programa de SEER
Análise de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188450



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