He Jiaxi, Shen Jianfei, Huang Jun, Dai Chenyang, Liang Wenhua, Ye Minhua, Kong Min, Chen Baofu, Zhu Chengchu, He Jianxing
Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.
J Surg Oncol. 2017 Jun;115(8):1004-1010. doi: 10.1002/jso.24611. Epub 2017 Apr 13.
To elucidate the survival outcomes of tracheal tumors and to propose the potential stage of tracheal tumors.
All cases of primary tracheal malignant tumors were extracted from the Surveillance, Epidemiology, and End Results database (SEER) during 1973-2013. The overall survival was calculated using Kaplan-Meier method. Cox regression was utilized to identify the prognostic factors.
A total of 287 cases were finally included. The median age of the patients was 59 years. Male patients accounted for 56.1%. The median survival was 57 months. Patients were categorized as Extension1 to 4 (E1-4) and N0-N3. E1 group with size <4 cm had the best prognosis. While E1 >4 cm, E2 and E3 <3 cm groups had similar outcomes, which were superior to E3 >3 cm group. E4 was the worst. N0 patients had ideal prognosis, which were better than N1 and N2 patients. The 3-year survival rates of each T category were 74.7%, 57.3%, 28.1%, and 9.1%, respectively. In multivariate analysis, age, histology, tumor size, and extension were independent prognostic factors.
Patients with old age, large tumor size, advanced extension or no surgery may have worse prognosis. The proposed T category of tracheal tumor incorporating tumor extension and size helped to predict survival outcomes.
阐明气管肿瘤的生存结果并提出气管肿瘤的潜在分期。
从监测、流行病学和最终结果数据库(SEER)中提取1973年至2013年期间所有原发性气管恶性肿瘤病例。采用Kaplan-Meier方法计算总生存率。利用Cox回归确定预后因素。
最终纳入287例病例。患者的中位年龄为59岁。男性患者占56.1%。中位生存期为57个月。患者被分为扩展1至4期(E1 - 4)和N0 - N3期。肿瘤大小<4 cm的E1组预后最佳。而E1>4 cm、E2和E3<3 cm组的结果相似,均优于E3>3 cm组。E4期最差。N0期患者预后理想,优于N1和N2期患者。各T分期的3年生存率分别为74.7%、57.3%、28.1%和9.1%。多因素分析显示,年龄、组织学类型、肿瘤大小和扩展是独立的预后因素。
年龄较大、肿瘤体积较大、扩展程度较高或未接受手术的患者预后可能较差。所提出的结合肿瘤扩展和大小的气管肿瘤T分期有助于预测生存结果。