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10.1001/jamasurg.2014.556 http://scihub22266oqcxt.onion/10.1001/jamasurg.2014.556 C4401470!4401470!25321323     free     free     free Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       JAMA+Surg 2014 ; 149 (12): 1244-53 Nephropedia Template TP {{tp|p=25321323|t=2014. Lobectomy, Sublobar Resection, and Stereotactic Radiation for Early-Stage Non-Small Cell Lung Cancers in the Elderly |pdf=|usr=}}{{25321323}} gab.com Text Lobectomy, Sublobar Resection, and Stereotactic Radiation for Early-Stage Non-Small Cell Lung Cancers in the Elderly JO: JAMA Surg http://www.kidney.de/pget.php?&tw=1&pmid=25321323 #FOAvip Importance: The incidence of early-stage non-small cell lung cancers among the elderly is expected to rise dramatically due to demographic trends and CT screening. However, no modern trials have compared the most commonly delivered treatments. Objective: To determine clinical characteristics and survival outcomes associated with the three most commonly utilized definitive therapies for early-stage NSCLC in the elderly population. Design, Setting, and Participants: The Surveillance, Epidemiology, and End Results?Medicare?linked database was used to determine the baseline characteristics and outcomes of 9,093 patients with early-stage, node-negative NSCLC who underwent definitive treatment with lobectomy, sublobar resection, or stereotactic ablative radiation between 2003 and 2009. Main Outcomes and Measures: Overall survival and lung-cancer specific survival were compared using Medicare claims through December 2012. Both proportional hazards regression and propensity score matching (PSM) were used to adjust outcomes for key patient, tumor, and practice environment factors. Results: The median age was 75 years, and treatment distribution was as follows: Lobectomy (79.4%), sublobar resection (16.5%), and SABR (4.2%). Unadjusted 90-day mortality was highest for lobectomy (4.0%) followed by sublobar resection (3.7%, P=0.79) and SABR (1.3%, P=0.008). At three years, unadjusted mortality was lowest for lobectomy (25.0%), followed by sublobar resection (35.3%, P<0.001) and SABR (45.1%, P<0.001). Proportional hazards regression demonstrated that sublobar resection was associated with worse overall survival (Adjusted hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.20?1.44) and lung-cancer specific survival (HR 1.50; 95%CI 1.29?1.75) compared to lobectomy. PSM analysis reiterated these findings. In proportional hazards regression, SABR was associated with better overall survival than lobectomy in the first 6 months after diagnosis (HR 0.45; 95%CI 0.27?0.75), but worse survival thereafter (HR 1.66; 95%CI 1.39?1.99). PSM analysis of well-matched SABR and lobectomy cohorts demonstrated similar overall survival in the two groups (HR 1.01; 95%CI 0.74?1.38). Conclusions: Lobectomy was associated with better outcomes than sublobar resection in elderly patients with early-stage NSCLC. Propensity-score matching suggests that SABR may be a good option among patients with very advanced age and multiple comorbidities. Twit Text FOAVip Lobectomy, Sublobar Resection, and Stereotactic Radiation for Early-Stage Non-Small Cell Lung Cancers in the Elderly ????JAMA Surg http://www.kidney.de/pget.php?&tw=1&pmid=25321323 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25321323 #FOAvip English Wikipedia <ref>{{Cite pmid|25321323}}</ref> Lobectomy, Sublobar Resection, and Stereotactic Radiation for Early-Stage Non-Small Cell Lung Cancers in the Elderly #MMPMID25321323 Shirvani SM; Jiang J; Chang JY; Welsh J; Likhacheva A; Buchholz TA; Swisher SG; Smith BD JAMA Surg 2014[Dec]; 149 (12): 1244-53 PMID25321323show ga Importance: The incidence of early-stage non-small cell lung cancers among the elderly is expected to rise dramatically due to demographic trends and CT screening. However, no modern trials have compared the most commonly delivered treatments. Objective: To determine clinical characteristics and survival outcomes associated with the three most commonly utilized definitive therapies for early-stage NSCLC in the elderly population. Design, Setting, and Participants: The Surveillance, Epidemiology, and End Results?Medicare?linked database was used to determine the baseline characteristics and outcomes of 9,093 patients with early-stage, node-negative NSCLC who underwent definitive treatment with lobectomy, sublobar resection, or stereotactic ablative radiation between 2003 and 2009. Main Outcomes and Measures: Overall survival and lung-cancer specific survival were compared using Medicare claims through December 2012. Both proportional hazards regression and propensity score matching (PSM) were used to adjust outcomes for key patient, tumor, and practice environment factors. Results: The median age was 75 years, and treatment distribution was as follows: Lobectomy (79.4%), sublobar resection (16.5%), and SABR (4.2%). Unadjusted 90-day mortality was highest for lobectomy (4.0%) followed by sublobar resection (3.7%, P=0.79) and SABR (1.3%, P=0.008). At three years, unadjusted mortality was lowest for lobectomy (25.0%), followed by sublobar resection (35.3%, P<0.001) and SABR (45.1%, P<0.001). Proportional hazards regression demonstrated that sublobar resection was associated with worse overall survival (Adjusted hazard ratio [HR] 1.32; 95% confidence interval [CI] 1.20?1.44) and lung-cancer specific survival (HR 1.50; 95%CI 1.29?1.75) compared to lobectomy. PSM analysis reiterated these findings. In proportional hazards regression, SABR was associated with better overall survival than lobectomy in the first 6 months after diagnosis (HR 0.45; 95%CI 0.27?0.75), but worse survival thereafter (HR 1.66; 95%CI 1.39?1.99). PSM analysis of well-matched SABR and lobectomy cohorts demonstrated similar overall survival in the two groups (HR 1.01; 95%CI 0.74?1.38). Conclusions: Lobectomy was associated with better outcomes than sublobar resection in elderly patients with early-stage NSCLC. Propensity-score matching suggests that SABR may be a good option among patients with very advanced age and multiple comorbidities. äLobectomy, Sublobar Resection, and Stereotactic Radiation for Early-St(epmc).pdf DeepDyve Pubget Overpricing