S. Zeidner

Medical University of Ohio at Toledo, Toledo, Ohio, United States

Are you S. Zeidner?

Claim your profile

Publications (4)12.88 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: This study compares the payors' cost of treatment for surgical Stage I endometrial carcinoma with results of published clinical studies to determine which treatment most efficiently uses available resources. Six options for treatment of surgical Stage I endometrial carcinoma were selected for comparison. The treatment options were observation only, low-dose-rate brachytherapy (LDRB) (nonremote afterloading), LDRB and external beam radiation (EBRT), EBRT only, high-dose-rate brachytherapy (HDRB) only (three applications), and EBRT and HDRB (three applications). The literature was reviewed to obtain disease-free survival (DFS) rates corresponding to the treatment options chosen in surgical Stages IA, IB, and IC. Metaanalysis and sensitivity testing were performed on the collected clinical data. A typical midsized city in Medicare region IV was used as our representative payor cost basis. Thirteen retrospective articles contained sufficient clinical information for analysis. Comparison of DFS between the observation, LDRB, and EBRT treatment groups was made for Stage IA; LDRB and EBRT for Stage IB; and LDRB, EBRT, LDRB +/- EBRT, LDRB + EBRT, and HDRB + EBRT for Stage IC. Meta-analysis failed to reveal statistically significant DFS between the respective treatment options within Stages IA, IB, or IC. The RVUs for each treatment option were LDRB, 21.7; EBRT, 117.1; EBRT + LDRB, 130.7; HDRB, 155.5; and EBRT + HDRB, 264.4. The DRG payment for LDRB is $2714.92. The calculated payor's cost for each treatment option was: LDRB, $3466.62; EBRT, $4053.03; EBRT + LDRB, $7238.55; HDRB, $5381.19; and EBRT + HDRB, $9153.14. Our analysis reveals no statistically significant differences in DFS among the treatment options considered within each surgical stage. Observation appears to result in acceptable DFS with minimal cost in Stage IA. Low-dose-rate brachytherapy was the most cost-effective treatment in Stage IB, with no statistically significant difference in DFS between LDRB and EBRT. Although LDRB had inferior DFS compared to other treatment options in surgical Stage IC, this difference failed to reach statistical significance. Our analysis implies, excluding observation, that LDRB may be a more cost-efficient treatment than the other treatment options considered. Further studies stratifying for surgical stage and grade are needed to determine the optimal cost-effective treatment for this common malignancy.
    No preview · Article · Feb 1997 · International Journal of Radiation OncologyBiologyPhysics
  • A. Konski · J. Mah · W. Eggelston · G. Phibbs · J. Neisler · S. Zeidner · G. Marsa

    No preview · Article · Dec 1996 · Radiotherapy and Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: ab: To evaluate and correlate the expression of pathologic characteristics, flow cytometric DNA content analysis, and estrogen and progesterone receptor levels with survival in patients with surgical Stage I endometrial carcinoma.: Hospital tumor registry records were surveyed, and this identified 232 patients diagnosed with endometrial adenocarcinoma between July 1, 1989, and December 30, 1993. DNA content analysis was performed on either paraffin-embedded or fresh tissue samples. Survival was calculated from the date of diagnosis by the Kaplan-Meier method. Postoperative irradiation (whole pelvis external beam therapy and low dose rate vaginal cuff brachytherapy) was delivered to patients felt to be at high risk for failure.: One hundred seventy-one patients had Stage I tumors and were available for analysis. Patients with Stage IC tumors had a statistically significant lower survival rate compared to patients with Stages IA or IB (p = 0.03 and p < 0.01, respectively). Patients with DNA content diploid tumors had a slightly increased (but nonsignificantly so) survival compared to patients with non-DNA content diploid tumors (p = 0.12). Logistic regression analysis failed to identify an independent prognostic factor that could predict for disease specific survival in patients with Stage I cancers.: Logistic regression analysis did not identify a single independent prognostic factor in patients with Stage I tumors. Pathologic characteristics reported to predict survival advantage correlated with pathologic stage. Additional translational research is needed to identify molecular characteristics of tumors that may indicate more aggressive treatment for patients at high risk for recurrence.
    No preview · Article · Aug 1996 · International Journal of Radiation OncologyBiologyPhysics
  • [Show abstract] [Hide abstract]
    ABSTRACT: We review our experience using interstitial implants in patients presenting with primary or recurrent gynecologic cancers. Between March 1990 and December 1993, a total of 30 patients (23 with primary tumors and seven with recurrent tumors) presented for interstitial implants. The reasons for the implants were narrowed vaginal apex not allowing two colpostats (seven); bulky cervical disease resulting in poor geometric placement of the colpostats (six); no identifiable cervical os (one); recurrent disease with previous irradiation (two); vaginal disease not appropriate for vaginal cylinder (13); and difficult tandem placement during intracavitary application (one). The mean implant dose was 30.90 Gy for the primary group and 31.57 Gy for the current group, with an overall control rate of 73%. Only one patient in the recurrence group has failed. The overall control rate was 69% for the primary group, with 13% having local failures and another 17% having distant failures only. Seven patients in the primary group have died, six of disease. Two minor complications have occurred in the recurrence group. The overall severe complication rate is 12%, with all three patients having fistulae. Associated recurrent cancer was noted in two of these patients. All the minor complications have resolved with observation or medical management.
    No preview · Article · Jan 1995 · Endocurietherapy/Hyperthermia Oncology