基于大型国家登记处数据的子宫颈小细胞癌患者淋巴结比率的预后价值
Prognostic value of lymph node ratio in patients with small-cell carcinoma of the cervix based on data from a large national registry.
作者信息
Zhou Juan, Sun Jia-Yuan, Chen Shan-Yu, Li Feng-Yan, Lin Huan-Xin, Wu San-Gang, He Zhen-Yu
机构信息
Department of Obstetrics and Gynecology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China.
Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.
出版信息
Onco Targets Ther. 2015 Dec 23;9:67-73. doi: 10.2147/OTT.S96206. eCollection 2016.
OBJECTIVE
To investigate the prognostic value of the lymph node ratio (LNR) in patients with small-cell carcinoma of the cervix (SCCC) after cancer-directed surgery using a population-based national registry (Surveillance Epidemiology and End Results [SEER]).
METHODS
We retrospectively reviewed the data of SCCC patients in the SEER database from 1980 to 2012. The prognostic impact of LNR with respect to cause-specific survival (CSS) and overall survival (OS) was analyzed.
RESULTS
A total of 118 patients with SCCC were identified. The median follow-up was 30.5 months. All these patients were treated with cancer-directed surgery and lymphadenectomy. Sixty (50.8%) patients had nodal metastases. The median LNR was 0.16 in patients with positive lymph nodes. Univariate analysis showed that prognostic factors such as International Federation of Gynecology and Obstetrics (FIGO) stage, nodal status, LNR, and local treatment modalities affected CSS and OS (P<0.05). Multivariate analysis showed that LNR was an independent prognostic factor for CSS and OS. Patients with a higher LNR had worse CSS (hazard ratio [HR]: 8.832; 95% confidence interval [CI]: 3.762-20.738; P<0.001) and OS (HR: 8.462; 95% CI: 3.613-19.821; P<0.001). LNR was associated with CSS and OS by stage, especially in FIGO stage I-II patients.
CONCLUSION
LNR is an independent prognostic factor in SCCC patients and it may help to individualize adjuvant therapy.
目的
利用基于人群的国家登记系统（监测、流行病学和最终结果 [SEER]），研究淋巴结比率（LNR）对子宫颈小细胞癌（SCCC）患者癌症导向手术后的预后价值。
方法
我们回顾性分析了SEER数据库中1980年至2012年SCCC患者的数据。分析了LNR对特定病因生存率（CSS）和总生存率（OS）的预后影响。
结果
共识别出118例SCCC患者。中位随访时间为30.5个月。所有这些患者均接受了癌症导向手术和淋巴结清扫术。60例（50.8%）患者有淋巴结转移。淋巴结阳性患者的中位LNR为0.16。单因素分析显示，国际妇产科联盟（FIGO）分期、淋巴结状态、LNR和局部治疗方式等预后因素影响CSS和OS（P<0.05）。多因素分析显示，LNR是CSS和OS的独立预后因素。LNR较高的患者CSS较差（风险比 [HR]：8.832；95%置信区间 [CI]：3.762-20.738；P<0.001），OS也较差（HR：8.462；95%CI：3.613-19.821；P<0.001）。LNR与各分期的CSS和OS相关，尤其是FIGO I-II期患者。
结论
LNR是SCCC患者的独立预后因素，可能有助于辅助治疗的个体化。
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