articles on survival
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Abstract Background Cancer patients with brain metastases BMs require multidisciplinary care, and treatment facility may play a role. This study aimed to investigate the impact of receiving treatment at articles on survival centers on the overall survival OS of cancer patients with brain metastases BMs regardless of the primary cancer site. Methods This retrospective analysis of the National Cancer Database NCDB included patients diagnosed with non-small cell lung cancer, small-cell lung cancer, other types of lung cancer, breast cancer, melanoma, colorectal cancer, and kidney cancer and had brain metastases at the time of diagnosis.
The Cox proportional hazard model adjusted for age at diagnosis, race, sex, place of living, income, articles on survival, primary tumor type, year of diagnosis, chemotherapy, radiation therapy RTand surgery of the primary cancer site was used to determine treatment facility-associated hazard ratios HR for survival. Overall survival was the primary outcome, which was analyzed with multivariable Cox proportional hazards regression modeling. Check this out on the log-rank analysis, patients who received treatment at an academic facility had significantly improved OS median OS: 6.
In the multivariable Cox regression analysis, receiving treatment at an academic facility was associated with significantly improved OS HR: 0.
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Conclusions In this extensive analysis of the NCDB, receiving treatment at academic centers was associated with significantly improved OS compared to treatment at non-academic centers. Supplementary Information The online version contains supplementary material available at Keywords: Brain metastases, Treatment facility, Overall survival, Radiation therapy, Surgery Background It is estimated syrvival each year more thanpeople are newly diagnosed with brain metastases BMs in the United States [ 1 ]. Brain metastases are ten times more common than the primary intracranial cancer and represent the most common intracranial malignancy in adults [ 2 — 5 ]. Brain metastases are associated with articles on survival morbidity and mortality and carry a poor survival prognosis [ 7 ].
The articles on survival overall survival OS of BMs patients depends on the primary cancer site and ranges between 4 and 16 months [ here — 10 ].
Targeted therapies and immunotherapies were associated with improved OS and intracranial response rate in BMs patients from melanoma, breast, non-small cell lung cancer NSCLCand renal cell carcinoma [ 13 — 20 ]. Nevertheless, proper management of brain metastasis requires multidisciplinary input about the appropriate integration of surgery, radiation, and systemic therapies.
Furthermore, the quality of life articles on survival patients aricles the long-term toxicity and complications of the treatments should also be carefully weighed when deciding on the treatment of BMs patients.
Associated Data
These therapeutic challenges require advanced multidisciplinary care and access to a robust health care team. Due to the highly specialized and interdisciplinary treatment approach being needed for BMs, hospital teaching status is to contribute to variation in patient survival outcomes.
Articles on survival addition to institutional variables such as the technical ability, presence of a robust and experienced health care team, and novel treatment modalities offered, certain patients related factors such as race, education, income, insurance can vary between academic and non-academic facilities and may affect the survival outcomes. Studies of various malignancies have indicated articles on survival the choice of treatments and survival outcomes varies by academic vs. Read more meta-analysis of head argicles neck cancer patients who received surgical resection of the tumor examined survival outcomes between patients treated at high volume vs.
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Treatment at academic hospitals was associated with Improved overall survival with a hazard ratio HR: 0. In this study, patients with Medicaid and patients from low-income articles on survival were less likely to receive treatment at academic centers [ 25 ]. Few studies of the Glioblastoma patients who underwent surgery reported improved OS for patients treated at academic centers compared to community treatment centers [ 26 — 28 ]. Better OS associated survoval receiving treatment at academic facilities link also been reported in resectable pancreatic cancer, intrahepatic cholangiocarcinoma, and metastatic NSCLC [ 29 — 31 ].
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Due to the complex treatment modalities articles on survival expertise needed for the treatments of BMs patients, the impact of academic or research treatment facilities on the OS of BMs patients must be investigated.
There have been no studies that articles on survival compared the OS of BMs patients regardless of the primary cancer site between academic and non-academic hospitals. The objective of this study is to examine the difference between the OS of BMs patients who receive treatment at academic hospitals and those who receive treatment at non-academic hospitals using the National Cancer Database NCDB. The NCDB is a multi-centers hospital-based cancer registry that was established in and now contains approximately 34 million records from hospital cancer registries across the United States. The data are extracted from patient charts by Certified Artilces Registrars, who undergo training specific to cancer registry operations.
This study was exempt from the institutional review board artiicles the de-identified data were used, and no consent was required.
Study artlcles Patients age 18 or older, who had brain metastases at the time of diagnosis and were diagnosed with the primary cancer of NSCLC, small-cell lung cancer SCLCother types of lung cancer, breast cancer, colorectal cancer, melanoma, and kidney cancer between andwere included in this study. Patients with M0, patients who were missing information about M stage, treatment facility, articles on survival to the primary site, RT, chemotherapy, and immunotherapy were excluded from the analysis.]
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