The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type.
The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type.
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DOI：
10.1186/s12885-021-08129-4
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发表时间：
2021-04-09
期刊：
影响因子：
3.8
通讯作者：
Lin C
中科院分区：
文献类型：
--
作者：
Amin S;Baine M;Meza J;Lin C
患有脑转移瘤（BM）的癌症患者需要多学科护理，治疗设施可能发挥作用。本研究旨在研究在学术中心接受治疗对脑转移（BM）癌症患者总生存期（OS）的影响，无论原发癌部位如何。这项对国家癌症数据库（NCDB）的回顾性分析包括诊断为非小细胞肺癌、小细胞肺癌、其他类型肺癌、乳腺癌、黑色素瘤、结直肠癌和肾癌并在诊断时有脑转移的患者。这些数据是从NCDB的去识别文件中提取的，NCDB是美国外科医生学院癌症委员会和美国癌症协会的联合项目。根据诊断时的年龄、种族、性别、居住地、收入、教育、原发肿瘤类型、诊断年份、化疗、放疗（RT）和原发癌部位手术进行校正的考克斯比例风险模型用于确定治疗机构相关的生存风险比（HR）。总生存期是主要结局，采用多变量考克斯比例风险回归模型进行分析。共分析了93，633例患者，其中31，579/93，633（34.09%）在学术中心接受治疗。基于对数秩分析，与在非学术机构接受治疗的患者相比，在学术机构接受治疗的患者的OS显著改善（中位OS：6.18，CI：6.05-6.31 vs. 4.57，CI：4.50-4.63个月; p < 0.001）。在多变量考克斯回归分析中，与非学术机构相比，在学术机构接受治疗与OS显著改善相关（HR：0.85，CI：0.84-0.87; p < 0.001）。在这项对NCDB的广泛分析中，与非学术中心的治疗相比，在学术中心接受治疗与OS显著改善相关。在线版本包含补充材料，可通过10.1186/s12885-021-08129-4获得。
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 academic centers on the overall survival (OS) of cancer patients with brain metastases (BMs) regardless of the primary cancer site. 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 data were extracted from the de-identified file of the NCDB, a joint program of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The Cox proportional hazard model adjusted for age at diagnosis, race, sex, place of living, income, education, primary tumor type, year of diagnosis, chemotherapy, radiation therapy (RT), and 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. A total of 93,633 patients were analyzed, among whom 31,579/93,633 (34.09%) were treated at academic centers. Based on the log-rank analysis, patients who received treatment at an academic facility had significantly improved OS (median OS: 6.18, CI: 6.05–6.31 vs. 4.57, CI: 4.50–4.63 months; p < 0.001) compared to patients who were treated at non-academic facilities. In the multivariable Cox regression analysis, receiving treatment at an academic facility was associated with significantly improved OS (HR: 0.85, CI: 0.84–0.87; p < 0.001) compared to non-academic facility. 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. The online version contains supplementary material available at 10.1186/s12885-021-08129-4.
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影响因子：
4.1
作者：
Cochran DC;Chan MD;Aklilu M;Lovato JF;Alphonse NK;Bourland JD;Urbanic JJ;McMullen KP;Shaw EG;Tatter SB;Ellis TL
通讯作者：
Ellis TL
影响因子：
4.1
作者：
Knisely JP;Yu JB;Flanigan J;Sznol M;Kluger HM;Chiang VL
通讯作者：
Chiang VL
DOI：
10.1016/s1470-2045(16)30053-5
发表时间：
2016-07
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Goldberg SB;Gettinger SN;Mahajan A;Chiang AC;Herbst RS;Sznol M;Tsiouris AJ;Cohen J;Vortmeyer A;Jilaveanu L;Yu J;Hegde U;Speaker S;Madura M;Ralabate A;Rivera A;Rowen E;Gerrish H;Yao X;Chiang V;Kluger HM
通讯作者：
Kluger HM
影响因子：
120.7
作者：
Chang, SM;Parney, IF;Laws, ER
通讯作者：
Laws, ER
影响因子：
13.8
作者：
Carey, Ryan M.;Fathy, Ramie;Brant, Jason A.
通讯作者：
Brant, Jason A.