In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient s...In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.展开更多
Background:Hodgkin lymphoma refers to a malignancy of the lymphatic tissue.Extra-nodal Hodgkin lymphoma(ENHL)is a rare variant consisting of Hodgkin lymphoma occurring outside the lymphatic system.Studies investigatin...Background:Hodgkin lymphoma refers to a malignancy of the lymphatic tissue.Extra-nodal Hodgkin lymphoma(ENHL)is a rare variant consisting of Hodgkin lymphoma occurring outside the lymphatic system.Studies investigating the epidemiology associated with ENHL are rare.Methods:618 ENHL cases were analyzed using the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)database(2000–2020).Demographics including sex,race/ethnicity,rural-urban continuum,age group(categorized as adolescent and young adult(AYA)if between years of 15 and 39,and adult if over the age of 40),and living status(alive/deceased)were examined,with survival status as the main outcome.Results:This study included 335 males(54.2%)and 283 females(45.8%).Of this total,47.9%were in the AYA group.In terms of ethnicity the distribution was 12.5%non-Hispanic Black,67.5%non-Hispanic White,5.2%non-Hispanic Asian/Pacific Islander,and 14.9%Hispanic.Bivariate analyses evidenced significant differences in survival by age group with 91.6%in AYA vs.72.4%in adults(P<0.001)alive by the end of the study period.Multivariable analyses identified age as a key predictor of survival,as the AYA patients had a lower odds ratio for death(odds ratio=0.25,P<0.001).In addition,survival outcomes were also impacted by race,with non-Hispanic Blacks showing higher survival probabilities.Regarding treatment,27.0%of patients underwent surgery,with 10.2%receiving post-surgery radiation,reducing odds of mortality(odds ratio=0.32,P=0.046).Conclusion:The background research as such,tends to affirm that these two factors–age and race are quite crucial in the prognosis as well as management of ENHL.Compared to adults,AYA patients had significantly lower odds of death,while non-Hispanic Black individuals exhibited reduced survival probabilities.It should be noted that 27.0%of patients underwent surgery with 10.2%receiving post-operative radiation which led to decrease in mortality rates.Thus,these results reiterate the necessity for tailor-made treatment methods according to demographic characteristics to boost patient outcomes effectively.For better ENHL care,future studies could shed light on these disparities and improve treatment regimens as needed.展开更多
目的:利用监测、流行病学和最终结果(surveillance,epidemiology,and end results,SEER)数据库构建列线图来预测老年早期HER2阳性乳腺癌患者的生存概率。方法:SEER数据库中筛选的5220名(基于单靶向治疗时代)和1176名(基于双靶向治疗时代...目的:利用监测、流行病学和最终结果(surveillance,epidemiology,and end results,SEER)数据库构建列线图来预测老年早期HER2阳性乳腺癌患者的生存概率。方法:SEER数据库中筛选的5220名(基于单靶向治疗时代)和1176名(基于双靶向治疗时代)患者被随机分为训练组和内部验证组。采用COX比例风险回归筛选生存相关预测因素并建立列线图模型,利用一致性指数(C-index)、校准曲线、受试者工作特征曲线(receiver operating characteristic curve,ROC)检验模型的准确性及实用性。对接受化疗和非化疗的患者使用两组倾向评分匹配进行统计配对,并对筛选的变量进行亚组分析。结果:单靶治疗时代列线图是由七个变量构建:年龄、婚姻状态、T分期、N分期、手术、化疗、放疗。双靶治疗时代列线图由两个变量构建:化疗和放疗。亚组分析结果表明,接受化疗的老年HER2阳性乳腺癌患者有更好的总生存期(OS)。结论:基于SEER数据库,建立并验证了预测老年早期HER2阳性乳腺癌患者生存率的准确列线图。该研究表明,化疗能增加老年患者的生存获益。展开更多
目的:明确影响胰腺胶样癌(colloid carcinoma,CC)患者预后的危险因素,构建临床预后模型,对患者生存预后进行评估。方法:选取美国国家癌症研究所监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)数据库中510...目的:明确影响胰腺胶样癌(colloid carcinoma,CC)患者预后的危险因素,构建临床预后模型,对患者生存预后进行评估。方法:选取美国国家癌症研究所监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)数据库中510例患者,将其分为训练集和验证集,并根据训练集的临床变量构建预后模型,以预测CC患者在1、3、5年的癌症特异性生存率的概率值,而后用验证集验证训练集筛选出的变量及校准预测模型。结果:利用SEER数据库筛选CC患者预后的影响因素,包括肿瘤分级、检出淋巴结数量、是否手术、T分期、是否转移,并根据以上影响因素构建了临床预后模型。受试者特征曲线及曲线下面积值表明本预测模型具有较高的准确性。校正曲线显示模型预测的生存率与实际生存率相近。结论:本研究构建出CC患者的临床预后模型,并利用此模型对患者的生存预后进行了有效评估,填补了这种罕见肿瘤预后研究的空白,为临床医生评估CC患者预后提供了一项有力依据。展开更多
利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料...利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料。将所有纳入研究的患者,按7∶3比例随机划分为训练集和验证集,采用方差分析对训练集及验证集的基本临床特征进行比较。通过生存分析及logistic回归,对口底鳞状细胞癌患者淋巴转移的预后及危险因素进行分析,并建立淋巴转移风险预测模型。最后,通过建立接收者操作特征(receiver operating characteristic,ROC)曲线、校准曲线及临床决策(decision curve analysis,DCA)曲线,对预测模型进行验证。本研究共纳入1946例患者,其中训练集1362例,验证集584例。方差分析显示,训练集和验证集各变量间差异无统计学意义(P>0.05)。生存分析显示,相较于无淋巴转移者,伴有淋巴转移者预后较差(P<0.05)。单因素logistic回归分析结果显示,年龄、性别、种族、Grade分级、是否为首要恶性肿瘤、T分期、M分期及肿瘤大小与淋巴转移相关(P<0.05)。多因素logistic回归分析结果则显示,年龄小于等于60岁、较高的Grade分级、为首要恶性肿瘤及较大的肿瘤尺寸,是口底鳞癌患者发生淋巴转移的独立风险预测因素(P<0.05)。基于多因素logistic回归结果,成功构建了预测口底鳞癌患者淋巴转移风险的列线图。ROC曲线、校准曲线及DCA曲线分析结果显示,该模型具有良好的预测性能及较高的临床获益。本研究确定了口底鳞癌患者淋巴转移的危险因素,建立并验证了口底鳞癌患者淋巴转移风险预测模型,该预测模型可作为口底鳞癌患者淋巴转移的评估工具。展开更多
目的:分析前列腺癌(PCa)患者第二原发恶性肿瘤(SPM)的发病趋势,探讨前列腺癌患者发生SPM的危险因素及其对生存的影响。方法:从SEER数据库(Surveillance,Epidemiology,and End Results Program database)中提取2004年至2016年前列腺癌患...目的:分析前列腺癌(PCa)患者第二原发恶性肿瘤(SPM)的发病趋势,探讨前列腺癌患者发生SPM的危险因素及其对生存的影响。方法:从SEER数据库(Surveillance,Epidemiology,and End Results Program database)中提取2004年至2016年前列腺癌患者作为研究队列,采用Joinpoint回归分析研究SPM的发病趋势。将患者分为仅患前列腺癌组(PCa组)和合并第二原发肿瘤组(PCa+1^(st) PM组),使用倾向性评分匹配(PSM)方法以平衡基线特征。绘制Kaplan-Meier生存曲线并构建竞争风险模型比较患者总体生存(OS)和肿瘤特异性生存(CSS)情况。采用Logistic回归分析确定SPM的独立危险因素,Cox回归分析确定独立预后因素。通过构建列线图模型对前列腺癌合并SPM人群的预后进行预测。结果:基于对SEER数据库大样本量研究队列数据的观察发现,PCa组和PCa+1^(st) PM组的发病率在1992年之前呈上升趋势,随后呈波动下降趋势。多因素Logistic回归分析发现,化疗是PCa术后发生SPM的独立危险因素(OR=1.43,95%CI 1.181~1.730,P<0.001);PCa患者合并SPM是OS较差的独立预后因素(HR=2.315,95%CI 2.260~2.369,P<0.001)。与对照组相比,手术(HR=0.62,95%CI 0.600~0.640,P<0.001)或放疗(HR=0.76,95%CI 0.741~0.779,P<0.001)可给予患者更好的生存获益。基于大样本量队列构建的列线图模型对PCa合并SPM患者的预后表现出良好的预测效果。结论:PCa术后化疗会增加患者罹患SPM的风险,且不能改善预后。SPM是PCa患者较差OS的独立预后因素。PCa的手术治疗和放疗可有效降低SPM患病风险,并使患者生存获益。本研究构建的PCa合并SPM特异性列线图模型,可有效预测该人群预后。展开更多
基金Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization(2021B1212040007)Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University,China(JNU1AF-CFTP-2022-a01235)Science and Technology Projects in Guangzhou,China(202201020054,2023A03J1032).
文摘In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.
文摘Background:Hodgkin lymphoma refers to a malignancy of the lymphatic tissue.Extra-nodal Hodgkin lymphoma(ENHL)is a rare variant consisting of Hodgkin lymphoma occurring outside the lymphatic system.Studies investigating the epidemiology associated with ENHL are rare.Methods:618 ENHL cases were analyzed using the National Cancer Institute’s Surveillance,Epidemiology,and End Results(SEER)database(2000–2020).Demographics including sex,race/ethnicity,rural-urban continuum,age group(categorized as adolescent and young adult(AYA)if between years of 15 and 39,and adult if over the age of 40),and living status(alive/deceased)were examined,with survival status as the main outcome.Results:This study included 335 males(54.2%)and 283 females(45.8%).Of this total,47.9%were in the AYA group.In terms of ethnicity the distribution was 12.5%non-Hispanic Black,67.5%non-Hispanic White,5.2%non-Hispanic Asian/Pacific Islander,and 14.9%Hispanic.Bivariate analyses evidenced significant differences in survival by age group with 91.6%in AYA vs.72.4%in adults(P<0.001)alive by the end of the study period.Multivariable analyses identified age as a key predictor of survival,as the AYA patients had a lower odds ratio for death(odds ratio=0.25,P<0.001).In addition,survival outcomes were also impacted by race,with non-Hispanic Blacks showing higher survival probabilities.Regarding treatment,27.0%of patients underwent surgery,with 10.2%receiving post-surgery radiation,reducing odds of mortality(odds ratio=0.32,P=0.046).Conclusion:The background research as such,tends to affirm that these two factors–age and race are quite crucial in the prognosis as well as management of ENHL.Compared to adults,AYA patients had significantly lower odds of death,while non-Hispanic Black individuals exhibited reduced survival probabilities.It should be noted that 27.0%of patients underwent surgery with 10.2%receiving post-operative radiation which led to decrease in mortality rates.Thus,these results reiterate the necessity for tailor-made treatment methods according to demographic characteristics to boost patient outcomes effectively.For better ENHL care,future studies could shed light on these disparities and improve treatment regimens as needed.
文摘目的:明确影响胰腺胶样癌(colloid carcinoma,CC)患者预后的危险因素,构建临床预后模型,对患者生存预后进行评估。方法:选取美国国家癌症研究所监测、流行病学和最终结果(Surveillance,Epidemiology,and End Results,SEER)数据库中510例患者,将其分为训练集和验证集,并根据训练集的临床变量构建预后模型,以预测CC患者在1、3、5年的癌症特异性生存率的概率值,而后用验证集验证训练集筛选出的变量及校准预测模型。结果:利用SEER数据库筛选CC患者预后的影响因素,包括肿瘤分级、检出淋巴结数量、是否手术、T分期、是否转移,并根据以上影响因素构建了临床预后模型。受试者特征曲线及曲线下面积值表明本预测模型具有较高的准确性。校正曲线显示模型预测的生存率与实际生存率相近。结论:本研究构建出CC患者的临床预后模型,并利用此模型对患者的生存预后进行了有效评估,填补了这种罕见肿瘤预后研究的空白,为临床医生评估CC患者预后提供了一项有力依据。
文摘利用监测、流行病学和最终结果(surveillance,epidemiology and end results,SEER)数据库进行口底鳞状细胞癌淋巴转移的危险因素分析及预测模型列线图构建。回顾分析2010年至2015年间美国SEER数据库中口底鳞状细胞癌患者的临床随访资料。将所有纳入研究的患者,按7∶3比例随机划分为训练集和验证集,采用方差分析对训练集及验证集的基本临床特征进行比较。通过生存分析及logistic回归,对口底鳞状细胞癌患者淋巴转移的预后及危险因素进行分析,并建立淋巴转移风险预测模型。最后,通过建立接收者操作特征(receiver operating characteristic,ROC)曲线、校准曲线及临床决策(decision curve analysis,DCA)曲线,对预测模型进行验证。本研究共纳入1946例患者,其中训练集1362例,验证集584例。方差分析显示,训练集和验证集各变量间差异无统计学意义(P>0.05)。生存分析显示,相较于无淋巴转移者,伴有淋巴转移者预后较差(P<0.05)。单因素logistic回归分析结果显示,年龄、性别、种族、Grade分级、是否为首要恶性肿瘤、T分期、M分期及肿瘤大小与淋巴转移相关(P<0.05)。多因素logistic回归分析结果则显示,年龄小于等于60岁、较高的Grade分级、为首要恶性肿瘤及较大的肿瘤尺寸,是口底鳞癌患者发生淋巴转移的独立风险预测因素(P<0.05)。基于多因素logistic回归结果,成功构建了预测口底鳞癌患者淋巴转移风险的列线图。ROC曲线、校准曲线及DCA曲线分析结果显示,该模型具有良好的预测性能及较高的临床获益。本研究确定了口底鳞癌患者淋巴转移的危险因素,建立并验证了口底鳞癌患者淋巴转移风险预测模型,该预测模型可作为口底鳞癌患者淋巴转移的评估工具。
