Sui Wilson, RoyChoudhury Arindam, Wenske Sven, Decastro Guarionex J, McKiernan James M, Anderson Christopher B
Department of Urology, Columbia University Medical Center, New York, NY.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
Urology. 2017 Feb;100:180-186. doi: 10.1016/j.urology.2016.09.042. Epub 2016 Oct 5.
To identify prognostic and treatment factors for primary urethral cancer using a nationwide database.
The National Cancer Database was queried for all cases of primary urethral cancer from 2004 to 2013. Patients with other cancer diagnoses, metastasis, or diagnosis on autopsy were excluded. Proportional hazards regression was used to identify independent predictors of overall survival in patients with primary urethral cancer. Because we hypothesized that predictors may covary by sex, we also performed regression analysis stratified by sex.
We identified 1268 men and 869 women with primary urethral cancer. Women tended to have more advanced tumors and adenocarcinoma histology. Median survival for the entire cohort was 49 months (43-55), with 5- and 10-year survival rates of 46% and 31%, respectively. On multivariate analysis, age, race, stage, grade, and Charlson comorbidity index were independent predictors of overall survival. Histology was not a predictor of overall survival in the combined model; however, adenocarcinoma in women increased hazards of death, whereas it decreased hazards of death in men when compared with squamous cell carcinoma.
Men and women with primary urethral cancer had significant differences in histology, grade, and nodal status. In addition to several expected disease-related factors, black race was associated with increased mortality for patients with primary urethral cancer.
利用全国性数据库确定原发性尿道癌的预后因素和治疗因素。
查询国家癌症数据库中2004年至2013年所有原发性尿道癌病例。排除有其他癌症诊断、转移或尸检诊断的患者。采用比例风险回归分析确定原发性尿道癌患者总生存的独立预测因素。由于我们假设预测因素可能因性别而异，因此我们还按性别进行了分层回归分析。
我们确定了1268例男性和869例女性原发性尿道癌患者。女性往往有更晚期的肿瘤和腺癌组织学类型。整个队列的中位生存期为49个月（43 - 55个月），5年和10年生存率分别为46%和31%。多因素分析显示，年龄、种族、分期、分级和查尔森合并症指数是总生存的独立预测因素。在综合模型中，组织学不是总生存的预测因素；然而，与鳞状细胞癌相比，女性腺癌增加死亡风险，而男性腺癌降低死亡风险。
原发性尿道癌男性和女性在组织学、分级和淋巴结状态方面存在显著差异。除了几个预期的疾病相关因素外，黑人种族与原发性尿道癌患者死亡率增加相关。
