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成年实体癌伴骨髓转移患者的预后因素。

Prognostic factors in adult patients with solid cancers and bone marrow metastases.

作者信息

Hung Yu-Shin, Chou Wen-Chi, Chen Tai-Di, Chen Tse-Ching, Wang Po-Nan, Chang Hung, Hsu Hung-Chih, Shen Wen-Chi, Cheng Wei-Hong, Chen Jen-Shi

机构信息

Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, and School of Medicine, Chang Gung University, Taoyuan, Taiwan E-mail :

出版信息

Asian Pac J Cancer Prev. 2014;15(1):61-7. doi: 10.7314/apjcp.2014.15.1.61.

Abstract

BACKGROUND

Solid cancers with bone marrow metastases are rare but lethal. This study aimed to identify clinical factors predictive of survival in adult patients with solid cancers and bone marrow metastases.

METHODS

A total of 83 patients were enrolled consecutively between January 1, 2000 and December 31, 2012. Bone marrow metastases were confirmed by biopsies. Patient clinical features and laboratory data were analyzed for associations.

RESULTS

The median age of the patients was 54 years (range, 23-88 years), and 58% were male. The 3 most common primary tumor locations were the stomach (32 patients, 39%), prostate (16 patients, 19%), and lungs (12 patients, 15%). The median overall survival was 49 days (range, 3-1423 days). Patients with Eastern Cooperative Oncology Group performance status 1, cancers of prostate origin, platelet counts over 50,000/ml, and undergoing antitumor therapies had a significantly better prognosis in the multivariate analysis. The median survival times were 173 and 33 days for patients with 2-3 more favorable parameters (n=24) and those with 0-1 (n=69), respectively (hazard ratio 0.30; 95% CI 0.17-0.52, p<0.001).

CONCLUSIONS

Solid cancers with bone marrow metastases are dismal and incurable diseases. Understanding prognostic factors to these diseases helps medical personnel to provide appropriate treatments and better inform patients about outcomes. Antitumor therapies may improve outcomes in selected patient cohorts.

摘要

背景

伴有骨髓转移的实体癌罕见但致命。本研究旨在确定成年实体癌伴骨髓转移患者生存的临床预测因素。

方法

2000年1月1日至2012年12月31日期间连续纳入83例患者。骨髓转移经活检确诊。分析患者临床特征和实验室数据以寻找相关性。

结果

患者中位年龄为54岁(范围23 - 88岁),58%为男性。3个最常见的原发肿瘤部位是胃(32例,39%)、前列腺(16例,19%)和肺(12例,15%)。中位总生存期为49天(范围3 - 1423天)。在多因素分析中,东部肿瘤协作组体能状态为1、前列腺来源癌症、血小板计数超过50,000/ml且接受抗肿瘤治疗的患者预后明显更好。具有2 - 3个更有利参数的患者(n = 24)和具有0 - 1个有利参数的患者(n = 69)的中位生存时间分别为173天和33天(风险比0.30;95%置信区间0.17 - 0.52,p < 0.001)。

结论

伴有骨髓转移的实体癌是预后差且无法治愈的疾病。了解这些疾病的预后因素有助于医务人员提供恰当治疗并更好地告知患者预后情况。抗肿瘤治疗可能改善部分特定患者群体的预后。

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