SEER Population-based Study Research Articles

Establishment of prognostic model for invasive ductal carcinoma with distant metastasis within the triple-negative breast cancer: a SEER population-based study

Establishment of prognostic model for invasive ductal carcinoma with distant metastasis within the triple-negative breast cancer: a SEER population-based study

Comparison of laparoscopic hepatectomy and radiofrequency ablation for small hepatocellular carcinoma patients: a SEER population-based propensity score matching study.

This study was designed to compare the efficacy of laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) in terms of their therapeutic effect on small hepatocellular carcinoma (SHCC). The SEER database was employed to integrate SHCC patients who had received treatment with either LH (n = 1132) or RFA (n = 797). The LH group (n = 623) and the RFA group (n = 623) were matched with 1:1 propensity score matching (PSM) in order to reduce the possibility of selection bias. The Kaplan-Meier method and Cox proportional hazards regression method were employed to ascertain the prognostic factors associated with overall survival (OS) and disease-specific survival (DSS). Both before and after PSM, the 1, 3 and 5-years OS and DSS were significantly higher in the LH groups compared to the RFA group. Besides, for SHCC with tumor size ≤ 2cm (n = 418), even P values not reaching statistical significance, the survival curves were compatible with a superiority of LH over RFA for OS and DSS in overall (P = 0.054 and P = 0.077), primary SHCC (P = 0.110 and P = 0.058) and recurrent SHCC (P = 0.068 and P = 1.000) cohorts. In contrast, for SHCC with tumor size between 2 and 3 cm (n = 828), LH group always had a better OS and DSS in the all cohorts (all P < 0.05). In addition, higher AFP level, poor differentiation grade, recurrent tumor and treatment type were independent prognostic factors for OS, while poor differentiation grade, larger tumor size and treatment type were the independent prognostic factors for DSS (all P < 0.05). LH was associated with better OS and DSS than RFA in SHCC patients. Even in tumor size ≤ 2cm, LH still should be the first choice as its long-term survival benefits.

Survival Prognostication in Patients with Differentiated Thyroid Cancer and Distant Metastases: A SEER Population-Based Study.

Background: For patients with thyroid cancer, distant metastasis is a significant predictor of poor outcome. Since distant metastasis occurs in less than 10% of patients with differentiated thyroid cancer, correlates of survival in this vulnerable patient population remain understudied. This study aimed to identify prognostic groups among patients with differentiated thyroid cancer and distant metastases and to determine the role of, and interactions between, patient and tumor characteristics in determining survival. Methods: We identified adult patients diagnosed with differentiated thyroid cancer with distant metastases from the U.S. SEER-17 cancer registry (2010-2019). Analyses were performed using Cox proportional hazards regression, survival trees, and random survival forest. Relative importance of patient and tumor factors important for disease-specific and overall survival was assessed based on the random survival forest analyses. Results: Cohort consisted of 2411 patients with differentiated thyroid cancer with distant metastases followed for a median of 62 months. Most common histopathologic subtype (86.0%) was papillary thyroid cancer, and the most common sites of distant metastasis were the lungs (33.7%) and bone (18.9%). Cox proportional hazards model illustrated significant associations between survival and the following: patient age (p < 0.001), tumor size (p < 0.01), and site of distant metastasis (p < 0.05). Survival tree analyses identified three distinct prognostic groups based on disease-specific survival (DSS) (5-year survival of the prognostic groups was 92%, 64%, and 41%; p < 0.001) and four distinct prognostic groups based on overall survival (OS) (5-year survival of the prognostic groups was 96%, 84%, 57%, and 31%; p < 0.001). The first split in the survival trees for DSS and OS was by age at diagnosis (≤57 years vs. ≥58 years) with subsequent splits based on presence/absence of lung metastases, tumor size (≤4 cm vs. >4 cm), and patient age. A total of 558 patients (23.1%) died from thyroid cancer, and 757 patients (31.4%) died from all causes during the study period. Conclusions: This study identifies distinct prognostic groups for patients with differentiated thyroid cancer with distant metastases and highlights the importance of patient age, lung metastases, and tumor size for determining both disease-specific and overall survival. These findings inform risk stratification and treatment decision-making in this understudied patient population.

Exploring the prognostic impact of differences in treatment strategies for SCLC with different histologies and prognostic factors for C-SCLC: A SEER population-based study

BackgroundCombined small cell lung cancer (C-SCLC) is a rare type of small cell lung cancer (SCLC), and it is controversial whether to choose the same treatment regimen as SCLC due to its multiple histologic components. Study methods and resultsRecords of patients with small cell lung cancer diagnosed between 2010 and 2020 were extracted using the SEER database. The OS of patients with different histological types under the same staging and treatment regimen was analyzed. It was found that early-stage (stage IA-IIA) surgical treatment, systemic chemotherapy alone, and chemoradiotherapy were more efficacious than C-SCLC and P-SCLC in patients with limited-stage (P = 0.054, P = 0.001, P = 0.019). In patients with extensive staging, the OS of patients with systemic chemotherapy regimens differed (P = 0.045) and was better in C-SCLC than in P-SCLC. We further explored the treatment strategy for patients with C-SCLC, which was shown by a COX regression model based on prognostic factors screened by Random Forest and LASSO regression models. Surgery, radiotherapy, and chemotherapy would be beneficial for survival. In a subgroup analysis based on stage and treatment regimen, it was shown that patients with early staging (stage IA-IIA) had a better prognosis with surgery (P < 0.001); in patients with extensive staging, chemoradiotherapy was favorable to the patient's prognosis (P = 0.022). ConclusionBoth limited-stage and extensive-stage C-SCLC patients are more sensitive to chemotherapy than P-SCLC patients. Patients with C-SCLC who have access to surgery should undergo surgery as early as possible, while chemoradiotherapy is recommended for patients with extensive staging. Patient age, gender, tumor size, surgery, chemotherapy, radiotherapy, and metastasis may individually affect patient prognosis.

Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study.

The role of age in metastatic disease, including breast cancer, remains obscure. This study was conducted to determine the role of age in patients with de novo metastatic breast cancer. Breast cancer patients diagnosed with distant metastases between 2010 and 2019 were retrieved from the Surveillance, Epidemiology, and End Results database. Comparisons were performed between young (aged ≤ 40 years), middle-aged (41-60 years), older (61-80 years), and the oldest old (> 80 years) patients. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariate Cox proportional hazard models. Survival analysis was performed by the Kaplan-Meier method. This study included 24155 (4.4% of all patients) de novo metastatic breast cancer patients. The number of young, middle-aged, older, and the oldest old patients were 195 (8.3%), 9397 (38.9%), 10224 (42.3%), and 2539 (10.5%), respectively. The 5-year OS rate was highest in the young (42.1%), followed by middle-aged (34.8%), older (28.3%), and the oldest old patients (11.8%). Multivariable Cox regression analysis showed that middle-aged (aHR, 1.18; 95% CI, 1.10-1.27), older (aHR, 1.42; 95% CI, 1.32-1.52), and the oldest old patients (aHR, 2.15; 95% CI, 1.98-2.33) had worse OS than young patients. Consistently, middle-aged (aHR, 1.16; 95% CI, 1.08-1.25), older (aHR, 1.32; 95% CI, 1.23-1.43), and the oldest old patients (aHR, 1.86; 95% CI, 1.71-2.03) had worse BCSS than young patients. This study provided clear evidence that de novo metastatic breast cancer had an age-specific pattern. Age was an independent risk factor for mortality in patients with de novo metastatic breast cancer.

Survival trends and conditional survival in primary non-metastatic esophageal cancer: a SEER population-based study and external validation

Survival trends and conditional survival in primary non-metastatic esophageal cancer: a SEER population-based study and external validation

Lobar or sublobar resection for early-stage second primary lung cancer ≤ 3 cm in size: a SEER population-based study

PurposeSurgical strategy for second primary lung cancer (SPLC) may be more conservative due to influence of first primary lung cancer (FPLC). The optimal surgical method for SPLC warrants discussion. We aimed to explore a more suitable surgical approach for early-stage (T1-T2N0, ≤ 3 cm) SPLC and provide insights for clinical practice.MethodsA retrospective study was conducted using data from the Surveillance, Epidemiology and End Results database between 2004 and 2018, and data of patients with early-stage SPLC who underwent secondary surgery were collected. Propensity score matching (PSM) reduced potential bias between lobar and sublobar resection groups. The effect of lobar and sublobar resection on overall survival (OS) was assessed in all patients and subgroups.ResultsA total of 714 patients who met the study entry criteria were enrolled, including 476 patients in the sublobar resection group (66.67%) and 238 patients in the lobar resection group (33.33%). There was no difference in OS between the lobar and sublobar resection groups before and after PSM (P = 0.289) and (P = 0.608), respectively. Subgroup analyses showed that lobar resection achieved a significantly better OS than sublobar resection only in patients with an SPLC tumor size of 2–3 cm (P < 0.05).ConclusionThe OS of sublobar resection was not significantly different from that of lobar resection for early-stage SPLC. For SPLC with a 2–3 cm tumor size, lobar resection is more advantageous than sublobar resection.

Value of thyroid cancer history in the prognosis of pancreatic cancer: a SEER population-based study

Thyroid cancer patients have a good prognosis, and their long survival increases the likelihood of developing a second primary tumor. Meanwhile, pancreatic cancer (PC) has a poor prognosis and therapeutic efficacy. However, the association between prior thyroid cancer and the subsequent PC prognosis is unknown. Herein, we selected pathologically diagnosed PC patients older than 17 between 2010 and 2015 from the SEER database. We used propensity score matching (PSM) to reduce confounding factors between groups and matched each PC patient with a history of thyroid cancer with 10 PC patients without a history of thyroid cancer. Finally, we selected 103 PC patients with prior thyroid cancer and 1030 PC patients without prior thyroid cancer. Then, we analyzed the factors influencing the overall survival (OS) and the cancer-specific survival (CSS) of PC patients. The median overall survival of PC patients with and without a history of thyroid cancer was 12 and 9 months, respectively. The history of thyroid cancer in PC patients reduced the PC-specific mortality (p < 0.05). Prior thyroid cancer might be a favorable prognostic factor for PC-specific mortality in PC patients.

Abstract P4-03-21: Racial disparities in survival trends in patients with metastatic Hormone receptor positive/Her 2 negative breast cancer: a SEER population-based study

Abstract Hormone-receptor-positive (HR+) breast cancer (BC) accounts for around 70% of all BCs[1]. Targeting the estrogen-receptor (ER) pathway has been the therapeutic focus; however, a substantial subset of HR+ BCs are resistant to hormonal blockade. Addition of Cyclin-dependent kinases 4 and 6 inhibitors (CDKis)to endocrine therapy has demonstrated to improve progression-free and overall survival in patients with metastatic ER+ BC. However, these trials enrolled mostly non-Hispanic White patients, with minimal inclusion of non-Hispanic Black and Hispanic patients. The goal of this study is to assess survival trends for different racial/ethnic groups in patients with HR+ HER2- BC before and after introduction of the CDKis as standard of care (year 2015). Methods: Using the SEER database of the National Cancer Institute, we identified patients with metastatic HR+ HER2- breast cancer. We obtained patients with ICD-0-3 codes 8500/3, 8501/3, 8502/3, 8503/3, 8507/3, 8520/3, 8521/3, 8522/3, 8523/3 and 8524/3. We divided them in two time-based cohorts: patients diagnosed in 2010-2013 and patient diagnosed in 2015-2018. SEER*STAT and Kaplan-Meir methods were used to estimate breast cancer specific survival at 6, 12, 24, 36 and 48 months for each group. Trends in survival were compared among Hispanic (H), Non-Hispanic White (NHW), and Non-Hispanic Black (NHB) patients. Results: We identified 10,019 patients that met our inclusion criteria, 4,667 (47%) diagnosed during 2010-2013 and 5,352 (53%) diagnosed during 2015-2018. For the patients diagnosed during 2010-2013, there were 4610 (99%) female and 57 (1%) were male. In the 2010-2013 group non-Hispanic white patients were 3,124 (67%) vs. 3,443 (64%) in 2015-2018, Non-Hispanic black patients were 639 (14%) vs. 736 (14%) and 521 (11%) vs. 645 (12%) were Hispanic of any race. For the 2010-2013 group, 3,463 (74%) had bone, 884 (19%) liver, 239 (5%) brain and 1,222 (26%) lung metastasis. There were 3,830 (83%) ER+/PR+ tumors, 777 (17%) ER+/PR- and 60 (1%) ER-/PR+. For the 2015-2018 group, there were 5266 (98%) female and 86 (2%) were male. 4011 (75%) had bone, 961 (18%) liver, 257 (4%) brain metastasis and 1469 (27%) lung metastasis. There were 4,424 (82%) ER+/PR+ tumors, 876(16%) ER+/PR- and 52 (1%) ER-/PR+. The 48-month BCSS rate for all patients improved from 2010-2013 to 2015-2018 (46.3% vs. 40.2 %), with an absolute improvement in 7.4%, 1.4%, 3.6% for NHW, NHB, and H patients, respectively. The 36-month BCSS rate for all patients improved from 2010-2013 to 2015-2018 (55.6% vs. 51.3%), with an absolute improvement in 4.9%, 2.6% for NHW, H patients, respectively, whereas NHB showed an absolute decrease of 4.5%. The 12-month BCSS rate for all patients improved from 2010-2013 to 2015-2018 (81.5% vs. 80.2%), with an absolute improvement in 2.4% and 0.8% for NHW, and H patients respectively. For NHB there was an absolute decrease in survival of 2.4%. Conclusions: Using population data, we report that the 48-month BCSS has improved from 2010-2013 to 2015-2018 by about 5.9%. However, the magnitude of the improvement was different by racial/ethnical groups. The magnitude of improvement in BCSS is higher in NHW as compared to NHB and H patients. Our results suggest that despite recent advancements in the management of ER+/HER2- metastatic BC, racial disparities in outcomes still persist which could be explained by either intrinsic genetic differences in response to novel agents or lack of access to them in some ethnical/racial groups. Citation Format: Alvaro Alvarez Soto, Ana Maria Bernal, Jesus Anampa Mesias. Racial disparities in survival trends in patients with metastatic Hormone receptor positive/Her 2 negative breast cancer: a SEER population-based study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-03-21.

Nomograms for predicting overall survival and cancer-specific survival of patients with stage IV renal cell carcinoma: A SEER population-based study

<sec><strong>Background</strong> The purpose of this study was to explore independent favorable prognostic factors for predicting 1-, 3-, and 5-year overall survival (OS) and cancer-specific survival (CSS) in patients with stage Ⅳ cell renal cell carcinoma (RCC) by constructing nomograms. </sec><sec><strong>Methods</strong> A total of 2636 patients diagnosed with stage Ⅳ RCC from 2010 to 2015 were enrolled in the surveillance, epidemiology, and end results database. Multivariate Cox hazard regression and competing risk analysis were used for searching prognosis factors in the cohort. The nomograms were constructed for predicting 1-, 3-, and 5-year of OS and CSS. Concordance index (C-index) and the calibration curves were used to evaluate the discrimination and accuracy of the nomograms. </sec><sec><strong>Results</strong> Age, nephrectomy, histology, N stage, and brain/liver/lung metastasis were identified as independent favorable prognostic factors in OS and CSS via univariate and multivariate analyses. Other variables were further selected by clinical practice and net reclassification improvement (NRI). Finally, age, nephrectomy, histology, grade, tumor size, T stage, N stage, and bone/brain/liver/lung metastasis were chosen to construct nomograms. The C-index of the OS and CSS in nomograms were 0.697 (95% confidence interval (CI), 0.683–0.711) and 0.655 (95% CI, 0.639–0.671), respectively. The calibration curves revealed high consistency between the nomograms prediction and actual observation. </sec><sec><strong>Conclusions</strong> The nomograms may help clinicians to conveniently predict the survival of RCC patients with stage Ⅳ and provide guidance in choosing the suitable management. </sec>

Occurrence and prognostic significance of different histology relative to urinary tract tumors: A SEER population-based study.

485 Background: To evaluate the prevalence and prognostic value of variant histology in urinary tract tumors according to primary location and metastatic status. Methods: Using the Surveillance, Epidemiology, and End Results registry (SEER, 2004-2015) databases, patients with urinary tract tumors were identified. Propensity Score Matching was used to balance the clinicopathologic features between different histologies. Kaplan-Meier plots were used to compare the cancer specific survival (CSS) and overall survival (OS) of different histologies. The cox regression analysis were also applied. Results: Of all 93,200 eligible patients with urinary tract tumors, 87,323 (93.7%) harbored bladder cancer (3,685 in M1 stage). Among them, urothelial tumors (UC) accounted for 96.67%, followed by squamous neoplasm (SCC), urachal carcinoma (Urachal), adenocarcinoma (Adeno), neuroendocrine tumors (NE) and tumor of Müllerian type (Müllerian). A total of 5877 (6.35%) harbored upper urinary tract tumors (950 in M1 stage). Among them, UC accounted for 96.39%, followed by SCC, Urachal, Müllerian, NE, Adeno. In patients with localized diseases, those with non-urothelial tumors had significantly worse prognosis in overall urinary tract tumors based on OS and CSS (P&lt;0.001). In terms of specific histology in bladder cancer (BC), patients with UC had most favorable prognosis, followed by Adeno, Urachal and Müllerian, while those with SCC and NE were associated with the worst survival outcomes. In patients with upper urinary tract tumors (UUTT), those with Müllerian had the best survival outcomes, followed by UC, while those with NE, Adeno, SCC, and Urachal had relatively worse prognosis. In M1 stage, although there was a statistical difference in OS and CSS between all patients with urothelial and non-urothelial tumors (P&lt;0.001), the 5-year survival rate (3.74%, 2.50%) and 5-year CSM (4.93%, 3.28%) were similar. In metastatic BC, there was no difference in OS among all histology. However, in terms of CSS, significant differences were still observed in patients with different histologies. In metastatic UUTT, no difference in survival was found among different histologies. After PSM, the similar results were observed in BC, while there is no statistical difference of survival among different histologies in UUTT, no matter the M stage. Cox analyses revealed that primary location, histology type, surgery, chemotherapy and M stage were the common and strong independent prognostic factors in both BC and UUTT. Conclusions: In urinary tract tumors, the incidence of different histology types between BC and UUTT is roughly similar. Overall, patient with variant histology have a worse prognosis than those with urothelial carcinoma. However, differences in survival among the histology types vary by primary location and metastatic status, especially the metastatic status.

Competing Risk Model to Determine the Prognostic Factors and Treatment Strategies for Adult Patients with Malignant Meningioma: a SEER Population-Based Study

Competing Risk Model to Determine the Prognostic Factors and Treatment Strategies for Adult Patients with Malignant Meningioma: a SEER Population-Based Study

Competing Risk Model to Determine the Prognostic Factors and Treatment Strategies for Adult Patients with Malignant Meningioma: a SEER Population-Based Study

Competing Risk Model to Determine the Prognostic Factors and Treatment Strategies for Adult Patients with Malignant Meningioma: a SEER Population-Based Study

Development and validation of a new stage-specific nomogram model for predicting cancer-specific survival in patients in different stages of colon cancer: A SEER population-based study and external validation.

The effects of laterality of the primary tumor on survival in patients in different stages of colon cancer are contradictory. We still lack a strictly evaluated and validated survival prediction tool, considering the different roles of tumor laterality in different stages. A total of 101,277 and 809 colon cancer cases were reviewed using the Surveillance, Epidemiology, and End Results database and the First Affiliated Hospital of Xi 'an Jiaotong University database, respectively. We established training sets, internal validation sets and external validation sets. We developed and evaluated stage-specific prediction models and unified prediction models to predict cancer-specific survival and compared the prediction abilities of these models. Compared with right-sided colon cancers, the risk of cancer-specific death of left-sided colon cancer patients was significantly higher in stage I/II but was markedly lower in stage III patients. We established stage-specific prediction models for stage I/II and stage III separately and established a unified prediction model for all stages. By evaluating and validating the validation sets, we reported high prediction ability and generalizability of the models. Furthermore, the stage-specific prediction models had better predictive power and efficiency than the unified model. Right-sided colon cancer patients have better cancer-specific survival than left-sided colon cancer patients in stage I/II and worse cancer-specific survival in stage III. Using stage-specific prediction models can further improve the prediction of cancer-specific survival in colon cancer patients and guide clinical decisions.

Low-grade hepatocellular carcinoma characteristics, a practical nomogram and risk stratification system: a SEER population-based study

ABSTRACT Background The purpose of this study is to establish a nomogram and risk stratification system to predict OS in patients with low-grade HCC Research design and methods Data were extracted from the SEER database. C-index, time-dependent AUCs, and calibration plots were used to evaluate the effective performance of the nomogram. NRI, IDI, and DCA curves were adopted to compare the clinical utility of nomogram with AJCC. Results 3415 patients with low-grade HCC were available. The C-indices for the training and validation cohorts were 0.773 and 0.772. The time-dependent AUCs in the training cohort were 0.821, 0.817, and 0.846 at 1, 3 and 5 years. Calibration plots for 1-, 3- and 5-year OS showed good consistency between actual observations and that predicted by the nomogram. The values of NRI at 1, 3, and 5 years were 0.37, 0.66, and 0.64. The IDI values at 1, 3, and 5 years were 0.11, 0.16, and 0.23 (P< 0.001). DCA curves demonstrated that the nomogram showed better ability of predicting 1-, 3-, and 5-year OS probabilities than AJCC. Conclusions A nomogram and risk stratification system for predicting OS in patients with low-grade HCC were established and validated.

Nomogram for predicting distant metastasis of male breast cancer: A SEER population-based study.

The main purpose of this study was to build a prediction model for male breast cancer (MBC) patients to predict the possibility of distant metastasis. The Surveillance, Epidemiology, and End Results database was used to obtain data on patients with MBC. The patients were divided into a training set and a validation set at a ratio of 7:3. The risk variables of distant metastasis in the training set were determined by univariate and multivariate logistic regression analyses. And then we integrated those risk factors to construct the nomogram. The prediction nomogram was further verified in the verification set. The discrimination and calibration of the nomogram were evaluated by the area under the receiver operating characteristic curve, calibration plots, respectively. A total of 1974 patients (1381 in training set and 593 in validation set) were eligible for final inclusion, of whom 149 (7.55%) had distant metastasis at the diagnosed time. Multivariate logistic regression analyses presented that age, T stage, N stage, and hormone receptor status were independent risk factors for distant metastasis at initial diagnosis of male breast cancer. Finally, the 4 variables were combined to construct the nomogram. The area under the curve values for the nomogram established in the training set and validation set were 0.8224 (95%CI: 0.7796–0.8652) and 0.8631 (95%CI: 0.7937–0.9326), suggesting that the nomogram had good predictive power. The calibration plots illustrated an acceptable correlation between the prediction by nomogram and the actual observation, as the calibration curve was closed to the diagonal bisector line. An easy-to-use nomogram, being proven to be with reliable discrimination ability and accuracy, was established to predict distant metastasis for male patients with breast cancer using the easily available risk factors.

34436 Trends in incidence and annual distribution of cutaneous malignant melanoma tumors based on breslow thickness at diagnosis: A SEER population-based study

Background: Among the U.S. population, the overall incidence rate of melanoma has increased steadily over the past three decades, yet mortality rates have remained relatively stable. This discrepancy has sparked suggestions that melanoma incidence rates have been inflated by more thorough surveillance measures, resulting in an overall increase of predominantly thinner melanoma lesions.

184P Comparison of survival outcomes between repeat sentinel lymph node biopsy and axillary lymph node dissection among patients with ipsilateral breast tumor recurrence: A SEER population-based study

Early-stage breast cancer patients are increasingly choosing breast-conserving surgery (BCS) and sentinel lymph node biopsy (SLNB). There is, however, a 14.3% to 20% chance of developing local recurrences. A lack of studies has assessed the survival benefit of repeat sentinel lymph node biopsy (rSLNB) over axillary lymph node dissection (ALND) in patients with ipsilateral breast tumor recurrence (IBTR).

Comparison of surgical resection and radiofrequency ablation for stages I and II elderly hepatocellular carcinoma patients (≥ 65 years): A SEER population-based propensity score matching's study.

ObjectivesThe treatment for hepatocellular carcinoma (HCC) remains controversial and limited in elderly patients. Therefore, we aimed to explore treatment choices for the elderly patients (≥ 65years) following surgical resection (SR) versus radiofrequency ablation (RFA) with HCC (single lesion less than 5 cm).MethodsWe used SEER database to identify HCC patients who received treatment of SR/RFA. Kaplan–Meier method and Cox proportional hazards regression method were used to determine the prognostic factors associated with overall survival (OS) and disease-specific survival (DSS). In addition, RFA group and SR group patients were matched with 1:1 propensity score matching (PSM) for diagnosis age, sex, race, marital, American Joint Committee on Cancer (AJCC), grade, radiotherapy, and chemotherapy to decrease the possibility of selection bias. Conditional disease-specific survival (CS) was estimated using the life-table method.ResultsA total of 794 patients who underwent SR and 811 patients who underwent RFA were confirmed from the SEER database. Surgery type was an independent risk factor for HCC. Survival analysis indicated that SR, races, AJCC I, no chemotherapy treatment, and grade I were cumulative risk factors that can significantly improve median survival for HCC (P < 0.05). After PSM analysis, only surgery type was significantly improved median survival of HCC patients (SR vs. RFA, HR: 0.644, 95% CI: 0.482–0.86; P < 0.001). For RFA group, the 2-, 3-, and 5-year CS rates were approximately 71%, 65%, and 62%, respectively, and corresponding to 82%, 80%, and 78% in the SR group.ConclusionSR treatment can provide survival benefits for elderly patients of <5 cm single lesion HCC.

Non-Linear Correlation Between Tumor Size and Survival Outcomes for Parathyroid Carcinoma: A SEER Population-Based Cohort Study.

BackgroundParathyroid carcinoma (PC) is a rare malignancy without a commonly acknowledged prognostic assessment and treatment system. This study captures how independent prognostic factors and tumor size correlate with outcomes in patients with PC.MethodsThe Surveillance, Epidemiology, and End Results database was used to perform a retrospective analysis on PC patients from 2000 to 2018. Univariate and multivariable survival analyses were performed to evaluate cancer-specific survival (CSS) and overall survival (OS), to identify independent prognostic factors in the PC patient population. A generalized additive model was applied to conduct smooth curve fitting and to examine the association between tumor size and relative risk of death.ResultsA total of 590 patients were included. The 5- and 10-year OS were 80.8% and 67.1%, respectively. 5- and 10-year CSS was estimated to be 93.6% and 92.1%, respectively. The association between tumor size and relative risk of death can be generalized as a U-shaped curve. The mortality risk reaches its lowest point when tumor diameter approaches 2cm. At a tumor diameter cutoff of 3cm for CSS and 4cm for OS, there is an abrupt drop in survival rates. Multivariate Cox analysis revealed age, no surgery, and debulking surgery as consistent predictors of lower OS and CSS.ConclusionsA non-linear correlation between tumor size and death risk has been identified in patients with PC, along with an accurate size threshold at which survival rates sharply decrease. Further investigation is needed to determine if these trends are seen in other malignancies with promising prognoses.