Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Spain.
BJU Int. 2012 Apr;109(8):1155-61. doi: 10.1111/j.1464-410X.2011.10479.x. Epub 2011 Aug 24.
To evaluate the prognostic role of ECOG Performance status (ECOG-PS) in a large multi-institutional international cohort of patients treated with radical nephroureterectomy for upper tract urothelial carcinoma.
Data of 427 patients treated with radical nephroureterectomy at five international institutions in Asia, Europe and Northern America were collected retrospectively from 1987 to 2008. Logistic and Cox regression models were used for univariable and multivariable analyses.
ECOG-PS was 0 in 272 of 427 (64%) patients. The median follow-up of the whole cohort was 32 months. The five-year recurrence-free (RFS), cancer-specific (CSS) and overall (OS) survival estimates were 71.7%, 74.9% and 68.5%, respectively, in patients with ECOG-PS 0 compared with 60.1%, 67.8%, and 51.4% respectively, in patients with ECOG-PS ≥1 (P value 0.08 for RFS, 0.43 for CSS, and <0.001 for OS, respectively). On multivariable Cox regression analyses, ECOG-PS was not an independent predictor of either RFS (hazard ratio 1.4; P = 0.107) or CSS (hazard ratio 1.2; P = 0.426) but was an independent predictor of OS (hazard ratio 1.5; P = 0.03).
In this large multicentre international study, ECOG-PS was not significantly associated with RFS and CSS. Conversely we find a strong association with survival 1-month after surgery and OS. Further research is needed to ascertain the additive prognostic role of ECOG-PS in well-designed prospective multicentre studies.
评估 ECOG 体能状态（ECOG-PS）在接受根治性肾输尿管切除术治疗上尿路上皮癌的大型多机构国际队列中的预后作用。
回顾性收集了 1987 年至 2008 年 5 个国际机构（亚洲、欧洲和北美）接受根治性肾输尿管切除术的 427 例患者的数据。使用逻辑和 Cox 回归模型进行单变量和多变量分析。
427 例患者中，ECOG-PS 为 0 的有 272 例（64%）。整个队列的中位随访时间为 32 个月。ECOG-PS 为 0 的患者 5 年无复发生存（RFS）、癌症特异性（CSS）和总生存（OS）估计值分别为 71.7%、74.9%和 68.5%，ECOG-PS≥1 的患者分别为 60.1%、67.8%和 51.4%（P 值分别为 0.08 用于 RFS、0.43 用于 CSS 和<0.001 用于 OS）。多变量 Cox 回归分析显示，ECOG-PS 不是 RFS（危险比 1.4；P = 0.107）或 CSS（危险比 1.2；P = 0.426）的独立预测因素，但与 OS（危险比 1.5；P = 0.03）独立相关。
在这项大型多中心国际研究中，ECOG-PS 与 RFS 和 CSS 无显著相关性。相反，我们发现它与术后 1 个月的生存和 OS 有很强的相关性。需要进一步的研究来确定 ECOG-PS 在设计良好的前瞻性多中心研究中的附加预后作用。
