Dataset Information

The prognosis of NX stage differentiated thyroid cancer based on propensity score matching and SEER data.

ABSTRACT: Few studies have evaluated the prognosis or treatment of patients with differentiated thyroid cancer (DTC) according to their NX status. This study investigated this issue to provide a new perspective regarding the treatment guidelines for these patients. Data from 92,447 patients with DTC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2013). Survival outcomes were evaluated using Kaplan-Meier analyses with the log-rank test and Cox proportional hazards regression analysis. The rates of cancer-specific mortality and all-cause mortality (per 1,000 person-years) were significantly higher for patients with NX disease, compared to patients with N0 or N1 disease. Multivariate Cox regression modeling revealed that NX stage was an independent risk factor for cancer-specific mortality compared to N1 stage, but not to N0 stage. Similar results were observed for all-cause mortality. After adjustment using propensity score matching, the cancer-specific and all-cause mortality rates were lower for NX stage compared to N0 stage, whereas no significant difference was observed when comparing the NX stage and N1 stage groups. The unexpectedly poor prognosis of patients with NX stage DTC provides new information that may be relevant for treating these patients.

SUBMITTER: Liu Z

PROVIDER: S-EPMC6291699 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The prognosis of NX stage differentiated thyroid cancer based on propensity score matching and SEER data.

Liu Zeming Z Zeng Wen W Zhao Qiuyang Q Huang Lei L Zhou Wei W Wei Wei W Zhou Ling L Guo Liang L

American journal of translational research 20181115 11

Few studies have evaluated the prognosis or treatment of patients with differentiated thyroid cancer (DTC) according to their NX status. This study investigated this issue to provide a new perspective regarding the treatment guidelines for these patients. Data from 92,447 patients with DTC were obtained from the Surveillance, Epidemiology, and End Results (SEER) database (2004-2013). Survival outcomes were evaluated using Kaplan-Meier analyses with the log-rank test and Cox proportional hazards ...[more]

PMID: 30662628

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Project description:BackgroundBreast surgery for stage IV breast cancer remains controversial. The aim of this study was to investigate the impact of breast surgery on survival of stage IV breast cancer patients based on the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015.MethodsIn total, 13,034 patients were selected and divided into surgery and non-surgery groups. Univariate and multivariable analyses were conducted to determine factors related to survival. Propensity score matching method was utilized to achieve balanced covariates across different groups. One-to-one (1:1) PSM was conducted to construct a matched sample consisting of pairs of surgery and non-surgery subjects. Breast cancer-specific survival (BCSS) and overall survival (OS) of the two groups were assessed by Kaplan-Meier plots and Cox proportional hazard regression models. Stratified analysis according to different variables was also performed.ResultsPatients treated with breast surgery were more likely to be younger, smaller tumor size, more advanced nodal status, higher histology grade and higher proportion of bone-only metastasis. Those who received chemotherapy and radiotherapy also tended to be treated with surgery. After adjustment for potential confounders, breast surgery group exhibited a better survival both in BCSS (HR = 0.557, 95% CI [0.523-0.594], p < 0.001) and OS (HR = 0.571, 95% CI [0.537-0.607], p < 0.001). After propensity score matching, the surgery and non-surgery group consisted of 2,269 patients respectively. The median survival time was 43 months for the surgery group and 27 months for the non-surgery group. Kaplan-Meier curves indicated that breast surgery could clearly improve both the BCSS and OS for patients with stage IV breast cancer. On multivariate analysis, surgery group was associated with a better survival compared with the non-surgery group (BCSS: HR = 0.542, 95% CI [0.499-0.589], p < 0.001; OS: HR = 0.555, 95% CI [0.512-0.601], p < 0.001). Furthermore, this survival advantage persisted in all subgroups irrespective of age, race, tumor size, nodal status, histology grade, molecular subtype, chemotherapy status, radiotherapy status or status of distant metastasis.ConclusionOur study provided additional evidence that patients with stage IV breast cancer could benefit from breast surgery and it might play a more important role in multimodality therapy.

Project description:BackgroundOvertreatment of papillary thyroid microcarcinoma (PTMC) has become a common concern. This study aimed to compare clinicopathological features between PTMC and papillary thyroid carcinoma (PTC) and to explore whether surgery can confer significant survival benefits in all patients with PTC or PTMC.MethodsData of 145,951 patients with PTC registered in Surveillance, Epidemiology, and End Results (SEER) database and 8,751 patients with PTC in our institution were retrospectively collected. Patients with tumors less than 10 mm in diameter were classified as PTMC cohort and the rest as PTC cohort. Clinicopathological features between PTMC and PTC were compared on the basis of SEER cohort and validated with institutional data. Survival analysis was conducted to explore the effect of surgery on the prognosis of patients. To minimize potential confounders and selection bias, we performed propensity score matching (PSM) analysis to match more comparable cohorts.ResultsCompared with PTC, PTMC exhibited the following characteristics: more common in women and whites, older age at diagnosis, lower proportion of follicular variants, intraglandular dissemination, extraglandular and capsular invasion, higher proportion of multifocality, fewer lymph node and distant metastases, and higher cancer-specific survival (CSS) and overall survival (OS) (all p-value < 0.05). Regarding treatment, patients with PTMC received a lower proportion of radiotherapy, chemotherapy, and total thyroidectomy but a higher proportion of lobectomy and/or isthmectomy. There was no significant difference in CSS for patients with PTMC at stage T1N0M0 with or without surgery (P = 0.36).ConclusionGenerally, PTMC showed higher biological indolence than PTC, which meant a higher survival rate for patients in both OS and CSS. For patients with PTMC at staged T1N0M0, active surveillance (AS) may be a potentially feasible management strategy. However, the maintenance of good medical compliance and the management of psychological burden cannot be ignored for patients included in AS.

Dataset Information

The prognosis of NX stage differentiated thyroid cancer based on propensity score matching and SEER data.

Publications

The prognosis of NX stage differentiated thyroid cancer based on propensity score matching and SEER data.

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