Using the National Cancer Database for Outcomes Research

Boffa, Daniel J.; Rosen, Joshua E.; Mallin, Katherine; Loomis, Ashley; Gay, Greer; Palis, Bryan E.; Thoburn, Kathleen K.; Gress, Donna M.; McKellar, Daniel P.; Shulman, Lawrence N.; Facktor, Matthew A.; Winchester, David P.

doi:10.1001/jamaoncol.2016.6905

Cited by 865 publications

(681 citation statements)

References 35 publications

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“…33,34 Multiple studies have shown that right-and left-sided cancers differ markedly in underlying biologic drivers. Further limitations of the NCDB are well summarized by Boffa et al 38 Although the implications of these epidemiologic data support changes in screening guidelines, large prospective screening studies of patients younger than 50 years are strongly needed to determine which younger patients are most at risk for CRC and to better determine the risks, benefits, and costs of screening this population. [35][36][37] Because of the differences in biology, the etiology of the rising prevalence in younger adults may differ in right and left colon cancers.…”

Section: Resultsmentioning

confidence: 99%

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Virostko

Capasso

Yankeelov

et al. 2019

Cancer

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BACKGROUND: The incidence of colorectal cancer (CRC) in adults younger than 50 years has increased in the United States over the past decades according to Surveillance, Epidemiology, and End Results data. National guidelines conflict over beginning screening at the age of 45 or 50 years. METHODS: This was a retrospective study of National Cancer Data Base data from 2004 to 2015. The Cochran-Armitage test for trend was used to assess changes in the proportion of cases diagnosed at an age younger than 50 years. RESULTS: This study identified 130,165 patients diagnosed at an age younger than 50 years and 1,055,598 patients diagnosed at the age of 50 years or older. The proportion of the total number of patients diagnosed with CRC at an age younger than 50 years rose (12.2% in 2015 vs 10.0% in 2004; P < .0001). Younger adults presented with more advanced disease (stage III/IV; 51.6% vs 40.0% of those 50 years old or older). Among men, diagnosis at ages younger than 50 years rose only in non-Hispanic whites (P < .0001), whereas among women, Hispanic and non-Hispanic whites had increases in younger diagnoses over time (P < .05). All income quartiles had a proportional increase in younger adults over time (P < .001), with the highest income quartile having the highest proportion of younger cases. The proportion of younger onset CRC cases rose in urban areas (P < .001) but did not rise in rural areas. CONCLUSIONS: The proportion of persons diagnosed with CRC at an age younger than 50 years in the United States has continued to increase over the past decade, and younger adults present with more advanced disease. These data should be considered in the ongoing discussion of screening guidelines. Cancer 2019;125:3828-3835.

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Section: Resultsmentioning

confidence: 99%

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Virostko

Capasso

Yankeelov

et al. 2019

Cancer

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“…A very abbreviated and less granular comorbidity scoring systems called Klabunde et al [20] or Deyo et al [21] adaptations of the originally validated Charlson comorbidity index [13] are included as a variable in some national databases such as National Cancer Database [22] or SEER-Medicare linked data sets to study outcomes [23]. In using these abbreviated tools, subjects are assigned a score of only 0, 1, or ≥2 in contrast to the original validated score used in the current study that can reach up to 25 points [13].…”

Section: Discussionmentioning

confidence: 99%

Does Age-Adjusted Charlson Comorbidity Score Impact Survival Endpoints in Women with Federation of Gynecology and Obstetrics-Stage III Endometrial Cancer?

Ghanem

Modh

Burmeister

et al. 2018

Gynecol Obstet Invest

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Objectives: We sought to evaluate the impact of age-adjusted Charlson comorbidity index (AACCI) score on survival endpoints for women with advanced stage endometrial carcinoma (EC). Methods and Materials: We identified 238 women with stage III EC. AACCI score was calculated and 3 groups were created accordingly; group 1 with a score of 0–2, group 2 with score 3–4, and group 3 with score ≥5. Significant predictors of recurrence-free (RFS), disease-specific (DSS) and overall survival (OS) were analyzed. Results: Median follow-up was 54 months and median age was 65 years. Stage IIIC was the most common stage (69%). The 3 groups were well-balanced except for less utilization of adjuvant chemotherapy in group 3 (p = 0.01). Five-year OS was significantly lower in group 3 compared to groups 1 and 2 (23 vs. 65 and 51%, respectively). Similarly, 5-year RFS was 54, 41, and 33% and DSS was 65, 54, and 35% for groups 1, 2, and 3 respectively. On multivariate analyses, AACCI group 3, cervical stromal involvement, positive peritoneal cytology, and higher tumor grade were predictors for shorter OS. Cervical stromal involvement and higher grade were independent predictors for worse RFS and DSS. Additionally, positive cytology, lymphovascular space invasion, and stage IIIC2 were significantly detrimental for RFS. Conclusions: Our study suggests that comorbidity burden is a strong predictor of worse OS in women with stage III EC. Women with higher AACCI are less likely to receive adjuvant chemotherapy. Comorbidity score can significantly impact survival endpoints for women with advanced EC.

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“…15,16 Patients with sarcomatoid HCC were identified from the NCDB Participant Use Data File using the combination of International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) topography code C22.0 (liver), histology code 8173, and behavior code 3 (malignant tumor). 14 As previously reported, the NCDB is a database collected and updated by the American College of Surgeons Commission on Cancer (CoC) and the American Cancer Society.…”

Section: Patients and Data Sourcementioning

confidence: 99%

Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

Tsilimigras

Farooq

et al. 2019

Cancer

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Background Few data are available regarding the management and outcomes among patients with sarcomatoid hepatocellular carcinoma (HCC) due to its rarity. Methods Patients diagnosed with sarcomatoid HCC from 2004 through 2015 were identified in the National Cancer Data Base. Overall survival (OS) was calculated among patients with sarcomatoid versus conventional HCC using a 1:3 propensity score matching based on sex, age, and American Joint Committee on Cancer (AJCC) stage of disease. Results The final analytic cohort included 104 patients with sarcomatoid HCC and 312 patients with conventional HCC. Patients with sarcomatoid HCC more often had a larger median tumor size (8.5 cm vs 5.4 cm; P < .001) and poorly or undifferentiated tumors (52.9% vs 13.8%; P < .001) compared with patients who had conventional HCC. 5‐year OS was worse among patients with sarcomatoid versus conventional HCC (5.7% vs 30.1%; P < .001). Subgroup analysis demonstrated worse 5‐year OS among patients with sarcomatoid versus conventional HCC among patients treated with either curative‐intent or palliative therapies. Stage‐specific subgroup analysis indicated a worse OS among patients with AJCC stage I, stage II, or stage III sarcomatoid HCC. On multivariable analysis, uninsured status, advanced AJCC stage (stage III/stage IV), and histological sarcomatoid subtype were independently associated with worse outcomes (all P < .05). Conclusions Sarcomatoid HCC is a very rare variant of HCC, which was associated with larger tumor size and worse tumor grade on presentation. On propensity score matched analyses that controlled for known confounding factors, patients with sarcomatoid HCC had a worse stage‐for‐stage long‐term survival compared with patients who had conventional HCC.

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Using the National Cancer Database for Outcomes Research

Cited by 865 publications

References 35 publications

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Recent trends in the age at diagnosis of colorectal cancer in the US National Cancer Data Base, 2004‐2015

Does Age-Adjusted Charlson Comorbidity Score Impact Survival Endpoints in Women with Federation of Gynecology and Obstetrics-Stage III Endometrial Cancer?

Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

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