Using the National Cancer Institute SEER database of (http://seer.cancer.gov/data/options.html), a retrospective analysis was conducted by exempting the data from the institutional review board's oversight. The project of SEER was initiated in 1973 in the USA as population-based registry of cancer which involves about one-tenth of the population in the country. The patient sample of the presented study was selected from the de-identified patients in the NCI SEER 18 Registries (SEER*Stat Database: Incidence-SEER. 18 Custom Data [with additional treatment fields] Nov 2016 Sub), whose data included no personal identifiers and were submitted to the NCI through electronic channels, which are allowed to be used in relevant medical research. The researchers of the present study had obtained the approval from the ethics committee and the institutional review board before using these de-identified data, including the clinicopathological features of the patients, tumor histology, cancer stage, timing and type of the first course treatment, and the therapeutic outcomes. A yearly follow-up rate of 90% for all involved patients whose cancer was diagnosed in recent five years was required for accreditation.

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