Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database
Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database....
Ausführliche Beschreibung
Autor*in: |
Nieto, Karina [verfasserIn] Adams, William [verfasserIn] Pham, Nghia [verfasserIn] Block, Alec M. [verfasserIn] Grover, Surbhi [verfasserIn] Small, William [verfasserIn] Harkenrider, Matthew M. [verfasserIn] |
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Format: |
E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2017 |
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Schlagwörter: |
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Übergeordnetes Werk: |
Enthalten in: Gynecologic oncology - Orlando, Fla. : Academic Press, 1972, 148 |
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Übergeordnetes Werk: |
volume:148 |
DOI / URN: |
10.1016/j.ygyno.2017.11.010 |
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Katalog-ID: |
ELV000707945 |
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245 | 1 | 0 | |a Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database |
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520 | |a Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. | ||
650 | 4 | |a Endometrial cancer | |
650 | 4 | |a Clear cell carcinoma | |
650 | 4 | |a Adjuvant therapy | |
650 | 4 | |a Vaginal brachytherapy | |
650 | 4 | |a External beam radiation therapy | |
650 | 4 | |a Chemotherapy | |
700 | 1 | |a Adams, William |e verfasserin |0 (orcid)0000-0002-5608-3808 |4 aut | |
700 | 1 | |a Pham, Nghia |e verfasserin |4 aut | |
700 | 1 | |a Block, Alec M. |e verfasserin |4 aut | |
700 | 1 | |a Grover, Surbhi |e verfasserin |4 aut | |
700 | 1 | |a Small, William |e verfasserin |4 aut | |
700 | 1 | |a Harkenrider, Matthew M. |e verfasserin |4 aut | |
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2017 |
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44.81 44.92 |
publishDate |
2017 |
allfields |
10.1016/j.ygyno.2017.11.010 doi (DE-627)ELV000707945 (ELSEVIER)S0090-8258(17)31506-8 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.92 bkl Nieto, Karina verfasserin aut Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database 2017 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy Adams, William verfasserin (orcid)0000-0002-5608-3808 aut Pham, Nghia verfasserin aut Block, Alec M. verfasserin aut Grover, Surbhi verfasserin aut Small, William verfasserin aut Harkenrider, Matthew M. verfasserin aut Enthalten in Gynecologic oncology Orlando, Fla. : Academic Press, 1972 148 Online-Ressource (DE-627)266881351 (DE-600)1467974-7 (DE-576)104193735 1095-6859 nnns volume:148 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2098 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.92 Gynäkologie AR 148 |
spelling |
10.1016/j.ygyno.2017.11.010 doi (DE-627)ELV000707945 (ELSEVIER)S0090-8258(17)31506-8 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.92 bkl Nieto, Karina verfasserin aut Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database 2017 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy Adams, William verfasserin (orcid)0000-0002-5608-3808 aut Pham, Nghia verfasserin aut Block, Alec M. verfasserin aut Grover, Surbhi verfasserin aut Small, William verfasserin aut Harkenrider, Matthew M. verfasserin aut Enthalten in Gynecologic oncology Orlando, Fla. : Academic Press, 1972 148 Online-Ressource (DE-627)266881351 (DE-600)1467974-7 (DE-576)104193735 1095-6859 nnns volume:148 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2098 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.92 Gynäkologie AR 148 |
allfields_unstemmed |
10.1016/j.ygyno.2017.11.010 doi (DE-627)ELV000707945 (ELSEVIER)S0090-8258(17)31506-8 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.92 bkl Nieto, Karina verfasserin aut Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database 2017 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy Adams, William verfasserin (orcid)0000-0002-5608-3808 aut Pham, Nghia verfasserin aut Block, Alec M. verfasserin aut Grover, Surbhi verfasserin aut Small, William verfasserin aut Harkenrider, Matthew M. verfasserin aut Enthalten in Gynecologic oncology Orlando, Fla. : Academic Press, 1972 148 Online-Ressource (DE-627)266881351 (DE-600)1467974-7 (DE-576)104193735 1095-6859 nnns volume:148 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2098 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.92 Gynäkologie AR 148 |
allfieldsGer |
10.1016/j.ygyno.2017.11.010 doi (DE-627)ELV000707945 (ELSEVIER)S0090-8258(17)31506-8 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.92 bkl Nieto, Karina verfasserin aut Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database 2017 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy Adams, William verfasserin (orcid)0000-0002-5608-3808 aut Pham, Nghia verfasserin aut Block, Alec M. verfasserin aut Grover, Surbhi verfasserin aut Small, William verfasserin aut Harkenrider, Matthew M. verfasserin aut Enthalten in Gynecologic oncology Orlando, Fla. : Academic Press, 1972 148 Online-Ressource (DE-627)266881351 (DE-600)1467974-7 (DE-576)104193735 1095-6859 nnns volume:148 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2098 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.92 Gynäkologie AR 148 |
allfieldsSound |
10.1016/j.ygyno.2017.11.010 doi (DE-627)ELV000707945 (ELSEVIER)S0090-8258(17)31506-8 DE-627 ger DE-627 rda eng 610 DE-600 44.81 bkl 44.92 bkl Nieto, Karina verfasserin aut Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database 2017 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy Adams, William verfasserin (orcid)0000-0002-5608-3808 aut Pham, Nghia verfasserin aut Block, Alec M. verfasserin aut Grover, Surbhi verfasserin aut Small, William verfasserin aut Harkenrider, Matthew M. verfasserin aut Enthalten in Gynecologic oncology Orlando, Fla. : Academic Press, 1972 148 Online-Ressource (DE-627)266881351 (DE-600)1467974-7 (DE-576)104193735 1095-6859 nnns volume:148 GBV_USEFLAG_U SYSFLAG_U GBV_ELV GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2007 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2098 GBV_ILN_2106 GBV_ILN_2108 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4313 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.81 Onkologie 44.92 Gynäkologie AR 148 |
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Enthalten in Gynecologic oncology 148 volume:148 |
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Enthalten in Gynecologic oncology 148 volume:148 |
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Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy |
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Gynecologic oncology |
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Nieto, Karina @@aut@@ Adams, William @@aut@@ Pham, Nghia @@aut@@ Block, Alec M. @@aut@@ Grover, Surbhi @@aut@@ Small, William @@aut@@ Harkenrider, Matthew M. @@aut@@ |
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2017-01-01T00:00:00Z |
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FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). 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Nieto, Karina ddc 610 bkl 44.81 bkl 44.92 misc Endometrial cancer misc Clear cell carcinoma misc Adjuvant therapy misc Vaginal brachytherapy misc External beam radiation therapy misc Chemotherapy Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database |
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610 DE-600 44.81 bkl 44.92 bkl Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database Endometrial cancer Clear cell carcinoma Adjuvant therapy Vaginal brachytherapy External beam radiation therapy Chemotherapy |
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Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database |
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adjuvant therapy in patients with clear cell endometrial carcinoma: an analysis of the national cancer database |
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Adjuvant therapy in patients with clear cell endometrial carcinoma: An analysis of the National Cancer Database |
abstract |
Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. |
abstractGer |
Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. |
abstract_unstemmed |
Objective: To assess the impact of adjuvant treatment, sociodemographic and tumor factors on the survival of patients with non-metastatic clear cell endometrial carcinoma (CCC).Methods: 4298 patients treated from 1998 to 2011 with Stage I–IVA CCC were identified within the National Cancer Database. FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. Given the aggressive nature of the disease, clinical trials are required to determine the optimal adjuvant therapy in patients with non-metastatic CCC to improve clinical outcomes. |
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FIGO 2009 staging system was used. Adjuvant groups included: hysterectomy (HYS); HYS+vaginal brachytherapy (VBT); HYS+chemotherapy (CT); HYS+external beam radiation therapy (EBRT); HYS+CT+EBRT; and HYS+CT+VBT. Univariable (UVA) and multivariable (MVA) frailty survival analyses were performed.Results: On UVA, higher stage was associated with an increased risk of death. Compared to stage I–IA, the risk of death for stage IB was HR 1.75 (95% CI, 1.50–2.04; p <0.001), stage II was HR 1.77 (95% CI, 1.50–2.10; p <0.001), stage III–IIIB was HR 3.29 (95% CI, 2.86–3.80; p <0.001), stage IIIC–IIIC2 was HR 3.33 (95% CI: 2.94–3.77; p <0.001), and stage IVA was 8.59 (95% CI: 6.60–11.18; p <0.001). Other meaningful predictors of death included black race (p <0.001), public insurance (p <0.001), geographic education attainment (p =0.001), greater comorbidity score (p =0.001), increasing age (p <0.001), and increasing tumor size (p <0.001). After controlling for stage, insurance, race, education attainment, comorbidity score, age, and tumor size adjuvant treatment was not associated with decreased risk of mortality (p =0.26).Conclusion: Adjuvant therapy did not have a meaningful effect on survival in this sample from the National Cancer Center Database. 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