Purpose: To determine the disparities in survival outcomes between stage IIB-IVA cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) treated with chemoradiotherapy.
Methods: Patients diagnosed between 2004 and 2015 were retrospectively included from the Surveillance, Epidemiology, and End Results databases. Propensity score matching (PSM) was used in this study. The primary endpoints were cervical cancer-specific survival (CCSS) and overall survival (OS).
Results: A total of 2752 patients were identified, including 87.5% (n=2408) were SCC and 12.5% (n=344) were AC. Patients with AC had inferior 5-year CCSS (67.5% vs 54.8%, P<0.001) and OS (58.4% vs 47.2%, P<0.001) compared to those with the SCC subtype. The hazard curve of cervical cancer-related death in AC peaked at 2 years (19%) and still small peaks in the 7 and 11 years of follow-up. Regarding SCC, cervical cancer-related deaths peaked at 2 years (15%) and the hazard rate was 2.0% during the six years of follow-up. The multivariate Cox regression analyses indicated that histology was an independent prognostic factor associated with survival outcomes. Patients with AC had significantly poor CCSS (P<0.001) and OS (P<0.001). Similar results were found after PSM.
Conclusion: Our study demonstrates a significantly better prognosis for cervical SCC patients compared to those with cervical AC undergoing chemoradiotherapy. These results highlight the importance of histological subtyping in predicting treatment outcomes and tailoring therapeutic strategies.
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http://dx.doi.org/10.2147/IJWH.S450457 | DOI Listing |
World Neurosurg
December 2024
Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; McKenna EpiLog Fellowship in Population Health, at the University of Pennsylvania, Philadelphia, PA, USA. Electronic address:
Background: While studies have examined the relationship between sex and outcomes after lumbar fusion surgery, few have strictly controlled for other patient-level variables. In this study, we use coarsened exact matching to determine the effect of patient-reported sex on spinal fusion outcomes.
Methods: Outcomes across 4680 consecutive adult single-level, posterior-only lumbar fusions at a multihospital academic medical center were retrospectively assessed.
Nurs Open
December 2024
School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA.
Aim: To discuss the need to expand advanced practice nurse education in Sub-Saharan Africa as a strategic response to the impact of the COVID-19 pandemic.
Design: Discursive paper.
Method: Searching international literature in PubMed, CINAHL and Google Scholar databases, we explored the impact of COVID-19 in Sub-Saharan Africa and the advanced practice nurse role and education in the pandemic response.
Curr Probl Cardiol
December 2024
Department of Medicine, Creighton University School of Medicine, 7710 Mercy Road, Suite 301, Omaha, Nebraska, United States of America 68124.
Introduction: Heart failure (HF) represents a significant contributor to morbidity and mortality. Heart failure mortality trends among the middle aged have not been fully characterized into the years of the COVID-19 pandemic. Our objective was to analyze the trends in mortality related to heart failure across various demographic and geographic categories-including gender, race, and census region-spanning from 1999 to 2022, with particular attention paid to the effect of the COVID-19 pandemic on HF mortality.
View Article and Find Full Text PDFCancer Epidemiol
December 2024
Department of Public Health Sciences, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA; Department of Surgery, Penn State College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Background: Cancer mortality rates are substantially higher in persistent poverty US counties compared to non-persistent poverty US counties. This study aimed to assess the prevalence of cancer risk behaviors by persistent poverty.
Methods: Counties with poverty rates of ≥ 20 % between 1990 and 2017-21 were classified as 'persistent poverty' (n = 318), and others were classified as 'non-persistent poverty' (n = 2801).
Am J Obstet Gynecol
December 2024
VA Health Economics Resource Center (HERC), US Department of Veterans Affairs, VA Palo Alto Health Care System, Menlo Park, CA, USA; VA HSR&D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, CA, USA; Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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