Skeletal-related events and mortality among men diagnosed with advanced prostate cancer: The impact of alternative measures of radiation to the boneReportar como inadecuado




Skeletal-related events and mortality among men diagnosed with advanced prostate cancer: The impact of alternative measures of radiation to the bone - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Purpose-Objectives

Skeletal-related events SREs, which include radiation to the bone RtB, can occur among patients with bone metastasis BM. There is a recognized potential for misclassification of RtB when using claims data. We compared alternative measures of RtB to better understand their impact on SRE prevalence and SRE-related mortality.

Methods and materials

We analyzed data for stage IV prostate cancer PCa cases identified between 2005 and 2009 in the Surveillance, Epidemiology, and End Results registry linked with Medicare claims. We created two measures of RtB: 1 a literature-based measure requiring the presence of a prior claim with a BM code; 2 a new measure requiring either that the BM code coincided with the radiation episode or that the duration of the radiation episode was less than or equal to 4 weeks. We estimated adjusted hazard ratios of an SRE using both measures among stratified samples: no metastasis M0, metastasis to bone M1b and other sites M1c.

Results

The study sample included 5,074 men with stage IV PCa median age 77 years, of whom 22% had M0, 54% had M1b, and 24% had M1c disease at time of PCa diagnosis. Based on Approaches 1 and 2, the proportion with probable RtB was 5% and 8% among M0, 30% and 30% among M1b, and 25% and 27% among M1c patients. Among M0 patients, the adjusted hazard ratio AHR associated with an SRE was 1.27 when using Approach 1 95% confidence interval, CI: 0.95–1.7 and 1.49 when using Approach 2 95% CI: 1.14–1.96. However, the impact of SREs on mortality did not differ between both approaches among M1b and M1c patients.

Conclusion

We found that alternative measures used to define RtB as SRE in claims data impact conclusions regarding the effect of SREs on mortality among M0 but not M1 patients.



Autor: Eberechukwu Onukwugha , Young Kwok , Jay P. Ciezki , Candice Yong , Catherine Plaisant , Chandana A. Reddy , C. Daniel Mullins ,

Fuente: http://plos.srce.hr/



DESCARGAR PDF




Documentos relacionados