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子宫颈癌骨转移患者生存预测模型

A prediction model of survival for patients with bone metastasis from uterine cervical cancer.

作者信息

Matsumiya Hiroko, Todo Yukiharu, Okamoto Kazuhira, Takeshita Sho, Yamazaki Hiroyuki, Yamashiro Katsushige, Kato Hidenori

机构信息

Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan.

Department of Obstetrics and Gynecology, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

J Gynecol Oncol. 2016 Nov;27(6):e55. doi: 10.3802/jgo.2016.27.e55. Epub 2016 Jun 20.

Abstract

OBJECTIVE

The aim of the study was to establish a predictive model of survival period after bone metastasis from cervical cancer.

METHODS

A total of 54 patients with bone metastasis from cervical cancer were included in the study. Data at the time of bone metastasis diagnosis, which included presence of extraskeletal metastasis, performance status, history of any previous radiation or chemotherapy, the number of bone metastases, onset period, and treatment were collected. Survival data were analyzed using Kaplan-Meier method and Cox proportional hazards model.

RESULTS

The median survival period after diagnosis of bone metastasis was 22 weeks (5 months). The 26- and 52-week survival rates after bone metastasis were 36.5% and 15.4%, respectively. Cox regression analysis showed that extraskeletal metastasis (hazard ratio [HR], 6.1; 95% CI, 2.2 to 16.6), performance status of 3 to 4 (HR, 7.8; 95% CI, 3.3 to 18.2), previous radiation or chemotherapy (HR, 3.3; 95% CI, 1.4 to 7.8), multiple bone metastases (HR, 1.9; 95% CI, 1.0 to 3.5), and a bone metastasis-free interval of <12 months (HR, 2.5; 95% CI, 1.2 to 5.3) were significantly and independently related to poor survival. A prognostic score was calculated by adding the number of each significant factor. The 26-week survival rates after diagnosis of bone metastasis were 70.1% in the group with a score ≤2, 46.7% in the group with a score of 3, and 12.5% in the group with a score ≥4 (p<0.001).

CONCLUSION

This scoring system provided useful prognostic information on survival of patients with bone metastasis of cervical cancer.

摘要

目的

本研究旨在建立宫颈癌骨转移后生存期的预测模型。

方法

本研究共纳入54例宫颈癌骨转移患者。收集骨转移诊断时的数据,包括骨外转移情况、体能状态、既往放疗或化疗史、骨转移灶数量、发病时间及治疗情况。采用Kaplan-Meier法和Cox比例风险模型分析生存数据。

结果

骨转移诊断后的中位生存期为22周(5个月)。骨转移后26周和52周的生存率分别为36.5%和15.4%。Cox回归分析显示,骨外转移(风险比[HR],6.1;95%置信区间[CI],2.2至16.6)、体能状态为3至4级(HR,7.8;95%CI,3.3至18.2)、既往放疗或化疗(HR,3.3;95%CI,1.4至7.8)、多发骨转移(HR,1.9;95%CI,1.0至3.5)以及骨转移无瘤间期<12个月(HR,2.5;95%CI,1.2至5.3)与生存不良显著且独立相关。通过将每个显著因素的数量相加计算出预后评分。骨转移诊断后,评分≤2分的组26周生存率为70.1%,评分为3分的组为46.7%,评分≥4分的组为12.5%(p<0.001)。

结论

该评分系统为宫颈癌骨转移患者的生存提供了有用的预后信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48cf/5078818/445cc5f380de/jgo-27-e55-g001.jpg

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