Dataset Information

Benefit from the inclusion of surgery in the treatment of patients with stage III pancreatic cancer: a propensity-adjusted, population-based SEER analysis.

ABSTRACT: In the past 20 years, surgical resection has been a secure and applicable procedure for pancreatic cancer (PC), but it remains controversial for stage III PC with data evaluating its efficacy mostly derived from small randomized trials. Hence, we designed this study to further evaluate its benefit using surveillance, epidemiology, and end results dataset.Patients with stage III PC were identified in the surveillance, epidemiology, and end results registries from 2004 to 2014. The effect of surgery on cancer-specific survival was assessed by risk-adjusted Cox proportional hazard regression modeling and propensity score matching.Overall, 6,138 patients with stage III PC were included. Of these, 608 patients underwent primary tumor surgery. On multivariable analyses, surgery was independently associated with improved cancer-specific survival (HR=0.580; 95% CI=0.523-0.643, p<0.001). The survival benefit with surgery was also observed in the propensity score-matched cohort (HR=0.501; 95% CI=0.438-0.573, p<0.001).Primary tumor surgery is associated with improved survival in stage III PC. Prospective randomized trials are needed to confirm these results, and further efforts are required to address patient selection.

SUBMITTER: Wang L

PROVIDER: S-EPMC6038853 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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Benefit from the inclusion of surgery in the treatment of patients with stage III pancreatic cancer: a propensity-adjusted, population-based SEER analysis.

Wang Lai L Cheng Chien-Shan CS Chen Lianyu L Chen Zhen Z

Cancer management and research 20180705

<h4>Purpose</h4>In the past 20 years, surgical resection has been a secure and applicable procedure for pancreatic cancer (PC), but it remains controversial for stage III PC with data evaluating its efficacy mostly derived from small randomized trials. Hence, we designed this study to further evaluate its benefit using surveillance, epidemiology, and end results dataset.<h4>Patients and methods</h4>Patients with stage III PC were identified in the surveillance, epidemiology, and end results regi ...[more]

PMID: 30013397

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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.

Dataset Information

Benefit from the inclusion of surgery in the treatment of patients with stage III pancreatic cancer: a propensity-adjusted, population-based SEER analysis.

Publications

Benefit from the inclusion of surgery in the treatment of patients with stage III pancreatic cancer: a propensity-adjusted, population-based SEER analysis.

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