دورية أكاديمية
Management and outcomes of clinical stage IIA/B seminoma: Results from the National Cancer Data Base 1998-2012.
العنوان: | Management and outcomes of clinical stage IIA/B seminoma: Results from the National Cancer Data Base 1998-2012. |
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المؤلفون: | Paly JJ; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Lin CC; Surveillance & Health Services Research Program, American Cancer Society, Atlanta, Georgia., Gray PJ; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Hallemeier CL; Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota., Beard C; Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts., Sineshaw H; Surveillance & Health Services Research Program, American Cancer Society, Atlanta, Georgia., Jemal A; Surveillance & Health Services Research Program, American Cancer Society, Atlanta, Georgia., Efstathiou JA; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: jefstathiou@partners.org. |
المصدر: | Practical radiation oncology [Pract Radiat Oncol] 2016 Nov - Dec; Vol. 6 (6), pp. e249-e258. Date of Electronic Publication: 2016 May 08. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101558279 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-8519 (Electronic) Linking ISSN: 18798500 NLM ISO Abbreviation: Pract Radiat Oncol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: New York : Elsevier |
مواضيع طبية MeSH: | Chemotherapy, Adjuvant* , Orchiectomy* , Radiotherapy, Adjuvant*, Neoplasm Recurrence, Local/*epidemiology , Seminoma/*therapy , Testicular Neoplasms/*therapy, Adult ; Databases, Factual ; Disease Management ; Hospitals, Community ; Hospitals, Teaching ; Humans ; Insurance, Health ; Kaplan-Meier Estimate ; Male ; Medicaid ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Odds Ratio ; Proportional Hazards Models ; Seminoma/mortality ; Seminoma/pathology ; Testicular Neoplasms/mortality ; Testicular Neoplasms/pathology ; United States/epidemiology ; Young Adult |
مستخلص: | Purpose/objective: Disease-specific survival for testicular seminoma approaches 100%, even for those with node-positive disease. We sought to describe modern practice patterns, survival outcomes, and factors associated with postoperative therapy for patients with clinical stage (CS) IIA/B disease. Methods and Materials: Data on patients diagnosed with CS IIA/B seminoma from 1998 to 2012 were extracted from the National Cancer Data Base. Demographic, clinical, treatment, and payer characteristics were evaluated using multivariate regression to identify factors associated with receipt of chemotherapy or radiation therapy (RT) within 6 months of orchiectomy. Five-year Kaplan-Meier overall survival (OS) by CS and treatment was calculated. A Cox proportional hazards regression for 5-year OS was performed. Results: A total of 1885 patients were included; 38.5% received chemotherapy and 61.5% received RT. On multivariate analysis, factors associated with receipt of postorchiectomy RT rather than chemotherapy included CS IIA (odds ratio [OR], 3.04; P < .01) and community treatment setting (OR, 1.81-2.76; P < .01). Reduced likelihood of receiving RT was associated with Medicaid insurance (OR, 0.50; P < .01), more recent year of diagnosis (continuous OR, 0.93; P < .01), and primary pathologic tumor 3/4 stage (OR, 0.47; P < .01). On multivariate Cox regression, decreased 5-year OS was associated with receipt of chemotherapy in CS IIA patients (hazard ratio, 13.33; P < .01) but not in CS IIB patients (hazard ratio, 1.39; P = .45). For CS IIA, 5-year OS was 99.4% for orchiectomy and RT versus 91.2% for orchiectomy and chemotherapy (log-rank P < .01). For CS IIB, 5-year OS was 96.1% for orchiectomy and RT versus 92.8% for orchiectomy and chemotherapy (log-rank P = .08). Conclusions: Consistent with national guideline recommendations, our analysis supports preferred status for RT in CS IIA. In addition, these data also support use of RT for CS IIB. CS, treatment year, primary pathologic tumor stage, insurance, and facility type were associated with type of postoperative therapy. Longer follow-up to account for potential late effects of treatment is needed. (Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.) |
تواريخ الأحداث: | Date Created: 20160628 Date Completed: 20170328 Latest Revision: 20170328 |
رمز التحديث: | 20231215 |
DOI: | 10.1016/j.prro.2016.05.002 |
PMID: | 27345128 |
قاعدة البيانات: | MEDLINE |
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