Idioma:

Comparative effectiveness of upfront treatment strategies in elderly women with ovarian cancer

Wright, Jason D. ; Ananth, Cande V. ; Tsui, Jennifer ; Glied, Sherry A. ; Burke, William M. ; Lu, Yu‐Shiang ; Neugut, Alfred I. ; Herzog, Thomas J. ; Hershman, Dawn L.

Cancer, 2014-04, Vol.120 (8), p.1246-1254 [Periódico revisado por pares]

Hoboken, NJ: Wiley-Blackwell

Texto completo disponível

Citações Citado por

Enviar para

Título:
Comparative effectiveness of upfront treatment strategies in elderly women with ovarian cancer
Autor: Wright, Jason D. ; Ananth, Cande V. ; Tsui, Jennifer ; Glied, Sherry A. ; Burke, William M. ; Lu, Yu‐Shiang ; Neugut, Alfred I. ; Herzog, Thomas J. ; Hershman, Dawn L.
Assuntos: Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Ovarian Epithelial ; Female ; Female genital diseases ; Gynecology. Andrology. Obstetrics ; Humans ; Medical sciences ; Multiple tumors. Solid tumors. Tumors in childhood (general aspects) ; Neoadjuvant Therapy ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial - mortality ; Neoplasms, Glandular and Epithelial - pathology ; Neoplasms, Glandular and Epithelial - therapy ; ovarian cancer, cytoreduction, debulking, oophorectomy, chemotherapy ; Ovarian Neoplasms - mortality ; Ovarian Neoplasms - pathology ; Ovarian Neoplasms - therapy ; Prognosis ; Proportional Hazards Models ; SEER Program ; Tumors
É parte de: Cancer, 2014-04, Vol.120 (8), p.1246-1254
Notas: This study used the linked Surveillance, Epidemiology, and End Results (SEER)‐Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the Applied Research Branch, Division of Cancer Prevention and Population Science, National Cancer Institute; the Office of Information Services, and the Office of Strategic Planning, HCFA; Information Management Services (IMS), Inc; and the SEER Program tumor registries in the creation of the SEER‐Medicare database.
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Descrição: BACKGROUND Observational studies comparing neoadjuvant chemotherapy to primary surgery for advanced‐stage ovarian cancer are limited by strong selection bias. Multiple methods were used to control for confounding and selection bias to estimate the effect of primary treatment on survival for ovarian cancer. METHODS The Surveillance, Epidemiology, and End Results (SEER)‐Medicare database was used to identify women ≥ 65 years of age with stage II‐IV epithelial ovarian cancer who survived > 6 months from the date of diagnosis and received treatment from 1991 through 2007. Traditional regression analysis, propensity score‐based analysis, and an instrumental variable analysis (IVA) using geographic location as an instrument were used to compare survival between neoadjuvant chemotherapy and primary surgery. RESULTS A total of 9587 patients with stage II‐IV ovarian cancer were identified. Use of primary surgery decreased from 63.2% in 1991 to 49.5% by 2007, whereas primary chemotherapy increased from 19.7% in 1991 to 31.8% in 2007 (P < .0001). In the observational cohort survival (hazard ratio [HR] = 1.27; 95% confidence interval [CI] = 1.19−1.35) was inferior for patients treated with neoadjuvant chemotherapy; both median survival (15.8 versus 28.8 months) and 2‐year survival (36% versus 56%) were lower in the neoadjuvant chemotherapy group compared to those who underwent surgery. In the IVA, primary treatment had minimal effect on overall survival (HR = 1.04; 95% CI = 0.67−1.60). The median survival for patients with a value of the instrument less than the median (24.0 months, 95% CI = 23.0−25.0) and greater than or equal to median value of the IV (24.0 months, 95% CI = 23.0−26.0) were similar. CONCLUSIONS Use of neoadjuvant therapy has increased over time. Survival with neoadjuvant chemotherapy did not differ significantly from primary surgery in elderly women in the United States. Cancer 2014;120:1246–1254. © 2014 American Cancer Society. Use of neoadjuvant therapy has increased over time. Survival with neoadjuvant chemotherapy compares favorably with primary surgery in elderly women in the United States.
Editor: Hoboken, NJ: Wiley-Blackwell
Idioma: Inglês

Links

Voltar para lista de resultados

Anterior Resultado 9 Avançar Ir para próxima página

Realização: Logos de Redes Sociais:

Comparative effectiveness of upfront treatment strategies in elderly women with ovarian cancer

Wright, Jason D. ; Ananth, Cande V. ; Tsui, Jennifer ; Glied, Sherry A. ; Burke, William M. ; Lu, Yu‐Shiang ; Neugut, Alfred I. ; Herzog, Thomas J. ; Hershman, Dawn L.

Hoboken, NJ: Wiley-Blackwell

Buscando em bases de dados remotas. Favor aguardar.