Octreotide long-acting repeatable among elderly patients with neuroendocrine tumors: A survival analysis of SEER-Medicare data

Chan Shen, Ya Chen Tina Shih, Ying Xu, James C. Yao

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Octreotide long-acting repeatable (LAR) is approved in the United States for the management of carcinoid syndromes among patients with neuroendocrine tumors (NET). The objective of our study is to evaluate the impact of octreotide LAR on overall survival (OS), as it has not been established. Methods: NET patients of 65 years and older diagnosed between January 1999 and December 2009 were identified from the SEER-Medicare database. We compared the OS of NET patients who started octreotide LAR within 12 months of diagnosis with those who did not receive it during the same period. We conducted Kaplan-Meier estimations and Cox proportional hazard models to examine the association between octreotide LAR and OS. Results: Among 1,176 distant stage patients, 233 (20%) received octreotide LAR within 12 months of diagnosis, compared with 2% (96 in 5,764) of local/regional stage patients. Median OS for patients who started octreotide LAR within 12 months was 35.22 months [95% confidence interval (CI), 27.96-47.77], longer than those who did not receive it (19.15 months; 95% CI, 16.36-22.80; P < 0.0001). Multivariate analysis showed that octreotide LAR was associated with significant survival improvement for distant stage patients (HR, 0.68; P < 0.001) and in the subgroups with (HR, 0.65; P, 0.003) and without (HR, 0.55; P, 0.002) carcinoid syndrome. No survival benefit was found among local/regional stage patients. Conclusion: This population-based study suggests potential survival benefits of octreotide LAR among elderly distant stage NET patients, both with or without carcinoid syndrome. Impact: The study provides population-based evidence of a positive association between octreotide LAR and overall survival among elderly distant stage NET patients.

Original languageEnglish (US)
Pages (from-to)1656-1665
Number of pages10
JournalCancer Epidemiology Biomarkers and Prevention
Volume24
Issue number11
DOIs
StatePublished - Nov 2015

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Octreotide
Neuroendocrine Tumors
Survival Analysis
Medicare
Survival
Carcinoid Tumor
Confidence Intervals
Proportional Hazards Models
Population
Multivariate Analysis
Databases

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

Cite this

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title = "Octreotide long-acting repeatable among elderly patients with neuroendocrine tumors: A survival analysis of SEER-Medicare data",
abstract = "Background: Octreotide long-acting repeatable (LAR) is approved in the United States for the management of carcinoid syndromes among patients with neuroendocrine tumors (NET). The objective of our study is to evaluate the impact of octreotide LAR on overall survival (OS), as it has not been established. Methods: NET patients of 65 years and older diagnosed between January 1999 and December 2009 were identified from the SEER-Medicare database. We compared the OS of NET patients who started octreotide LAR within 12 months of diagnosis with those who did not receive it during the same period. We conducted Kaplan-Meier estimations and Cox proportional hazard models to examine the association between octreotide LAR and OS. Results: Among 1,176 distant stage patients, 233 (20{\%}) received octreotide LAR within 12 months of diagnosis, compared with 2{\%} (96 in 5,764) of local/regional stage patients. Median OS for patients who started octreotide LAR within 12 months was 35.22 months [95{\%} confidence interval (CI), 27.96-47.77], longer than those who did not receive it (19.15 months; 95{\%} CI, 16.36-22.80; P < 0.0001). Multivariate analysis showed that octreotide LAR was associated with significant survival improvement for distant stage patients (HR, 0.68; P < 0.001) and in the subgroups with (HR, 0.65; P, 0.003) and without (HR, 0.55; P, 0.002) carcinoid syndrome. No survival benefit was found among local/regional stage patients. Conclusion: This population-based study suggests potential survival benefits of octreotide LAR among elderly distant stage NET patients, both with or without carcinoid syndrome. Impact: The study provides population-based evidence of a positive association between octreotide LAR and overall survival among elderly distant stage NET patients.",
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Octreotide long-acting repeatable among elderly patients with neuroendocrine tumors : A survival analysis of SEER-Medicare data. / Shen, Chan; Shih, Ya Chen Tina; Xu, Ying; Yao, James C.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 24, No. 11, 11.2015, p. 1656-1665.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Octreotide long-acting repeatable among elderly patients with neuroendocrine tumors

T2 - A survival analysis of SEER-Medicare data

AU - Shen, Chan

AU - Shih, Ya Chen Tina

AU - Xu, Ying

AU - Yao, James C.

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N2 - Background: Octreotide long-acting repeatable (LAR) is approved in the United States for the management of carcinoid syndromes among patients with neuroendocrine tumors (NET). The objective of our study is to evaluate the impact of octreotide LAR on overall survival (OS), as it has not been established. Methods: NET patients of 65 years and older diagnosed between January 1999 and December 2009 were identified from the SEER-Medicare database. We compared the OS of NET patients who started octreotide LAR within 12 months of diagnosis with those who did not receive it during the same period. We conducted Kaplan-Meier estimations and Cox proportional hazard models to examine the association between octreotide LAR and OS. Results: Among 1,176 distant stage patients, 233 (20%) received octreotide LAR within 12 months of diagnosis, compared with 2% (96 in 5,764) of local/regional stage patients. Median OS for patients who started octreotide LAR within 12 months was 35.22 months [95% confidence interval (CI), 27.96-47.77], longer than those who did not receive it (19.15 months; 95% CI, 16.36-22.80; P < 0.0001). Multivariate analysis showed that octreotide LAR was associated with significant survival improvement for distant stage patients (HR, 0.68; P < 0.001) and in the subgroups with (HR, 0.65; P, 0.003) and without (HR, 0.55; P, 0.002) carcinoid syndrome. No survival benefit was found among local/regional stage patients. Conclusion: This population-based study suggests potential survival benefits of octreotide LAR among elderly distant stage NET patients, both with or without carcinoid syndrome. Impact: The study provides population-based evidence of a positive association between octreotide LAR and overall survival among elderly distant stage NET patients.

AB - Background: Octreotide long-acting repeatable (LAR) is approved in the United States for the management of carcinoid syndromes among patients with neuroendocrine tumors (NET). The objective of our study is to evaluate the impact of octreotide LAR on overall survival (OS), as it has not been established. Methods: NET patients of 65 years and older diagnosed between January 1999 and December 2009 were identified from the SEER-Medicare database. We compared the OS of NET patients who started octreotide LAR within 12 months of diagnosis with those who did not receive it during the same period. We conducted Kaplan-Meier estimations and Cox proportional hazard models to examine the association between octreotide LAR and OS. Results: Among 1,176 distant stage patients, 233 (20%) received octreotide LAR within 12 months of diagnosis, compared with 2% (96 in 5,764) of local/regional stage patients. Median OS for patients who started octreotide LAR within 12 months was 35.22 months [95% confidence interval (CI), 27.96-47.77], longer than those who did not receive it (19.15 months; 95% CI, 16.36-22.80; P < 0.0001). Multivariate analysis showed that octreotide LAR was associated with significant survival improvement for distant stage patients (HR, 0.68; P < 0.001) and in the subgroups with (HR, 0.65; P, 0.003) and without (HR, 0.55; P, 0.002) carcinoid syndrome. No survival benefit was found among local/regional stage patients. Conclusion: This population-based study suggests potential survival benefits of octreotide LAR among elderly distant stage NET patients, both with or without carcinoid syndrome. Impact: The study provides population-based evidence of a positive association between octreotide LAR and overall survival among elderly distant stage NET patients.

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