基于对6380例患者的分析提出的小肠类癌肿瘤分期系统。

A proposed staging system for small bowel carcinoid tumors based on an analysis of 6,380 patients.

作者信息

Landry Christine S, Brock Guy, Scoggins Charles R, McMasters Kelly M, Martin Robert C G

机构信息

Division of Surgical Oncology, Department of Surgery and James Graham Brown Cancer Center, University of Louisville, School of Medicine, Louisville, KY, USA.

出版信息

Am J Surg. 2008 Dec;196(6):896-903; discussion 903. doi: 10.1016/j.amjsurg.2008.07.042.

DOI:10.1016/j.amjsurg.2008.07.042

PMID:19095106

Abstract

BACKGROUND

Little is known about the long-term prognosis of small bowel carcinoids because currently no staging system exists.

METHODS

A search of the Surveillance, Epidemiology and End Results (SEER) database identified 6,380 patients with small bowel carcinoid tumors from 1977 to 2004. Patients were analyzed according to various clinicopathologic factors and a tumor (T1, T2, T3), lymph node (N0, N1), and metastasis (M0, M1) staging system was created according to these parameters.

RESULTS

Among the 6,380 patients, 2,985 women and 3,395 men, with a median age of 66 years (range 14-98), the median tumor size was 1.9 cm (range .1-30 cm). Multivariate analysis demonstrated that age, size of the primary tumor, and depth of invasion were significant factors. Four stages were created according to statistically significant prognostic factors: 13% of patients were classified into stage I, 31% into stage II, 16% into stage III, and 40% into stage IV. Five-year survival rates were 96%, 87%, 74%, and 43% for stages I through IV, respectively.

CONCLUSIONS

The newly developed TNM staging system accurately discriminates prognosis for small bowel carcinoid tumors.

摘要

背景

由于目前尚无分期系统，关于小肠类癌的长期预后所知甚少。

方法

检索监测、流行病学与最终结果（SEER）数据库，确定了1977年至2004年间6380例小肠类癌肿瘤患者。根据各种临床病理因素对患者进行分析，并根据这些参数创建了肿瘤（T1、T2、T3）、淋巴结（N0、N1）和转移（M0、M1）分期系统。

结果

在6380例患者中，女性2985例，男性3395例，中位年龄66岁（范围14 - 98岁），肿瘤中位大小为1.9 cm（范围0.1 - 30 cm）。多因素分析表明，年龄、原发肿瘤大小和浸润深度是显著因素。根据具有统计学意义的预后因素划分出四个阶段：13%的患者被归类为I期，31%为II期，16%为III期，40%为IV期。I至IV期的五年生存率分别为96%、87%、74%和43%。