1988年至2011年子宫浆液性癌患者的生存趋势：一项基于人群的研究。

Trends in Survival of Patients With Uterine Serous Carcinoma From 1988 to 2011: A Population-Based Study.

作者信息

Mahdi Haider, Han Xiaozhen, Moulton Laura, Vargas Roberto

机构信息

*Gynecologic Oncology Division, Ob/Gyn and Women's Health Institute, Cleveland Clinic; and †Population Health and Outcomes Research Core, Clinical and Translational Science Collaborative, Cleveland, OH.

出版信息

Int J Gynecol Cancer. 2017 Jul;27(6):1155-1164. doi: 10.1097/IGC.0000000000001007.

DOI:10.1097/IGC.0000000000001007

PMID:28562471

Abstract

OBJECTIVE

Our study used the Surveillance, Epidemiology, and End Result database to determine if the changes in treatment paradigm observed over the last 2 decades have improved outcomes in patients with uterine serous carcinoma (USC).

METHODS

Women with USC were identified using the Surveillance, Epidemiology, and End Result database from 1988 to 2011 (n = 8230) and grouped into 3 cohorts (1988-1997, 1998-2004, and 2005-2011). Disease-specific survival and overall survival were estimated. Kaplan-Meier survival curves and Cox regression models were used.

RESULTS

Disease-specific survival (59 vs 94 months vs not reached; P < 0.001) and overall survival (31 vs 37 vs 45 months; P < 0.001) improved over time. In univariable analyses, only those with stage I-III and those who reside in the Western or Central regions were noted to have improvement over time. In multivariable analyses when adjusting for age, race, marital status, stage, geographic location, cancer-related surgery, extent of lymphadenectomy, and adjuvant radiation, patients who received the diagnosis during 2005 to 2011 were 22% less likely to die of uterine cancer (hazard ratio [HR], 0.78; 95% confidence interval [CI], 0.70-0.87; P < 0.001) and 17% less likely to die of any cause (HR, 0.83; 95% CI, 0.76-0.90; P < 0.0001) compared with patients who received a diagnosis during 1988-1997. Similarly, patients who received a diagnosis during 1998-2004 were 15% less likely to die of uterine cancer (HR, 0.85; 95% CI, 0.77-0.94; P = 0.0015) and 10% less likely to die of any cause (HR, 0.90; 95% CI, 0.83-0.97; P = 0.0048) compared with patients who received a diagnosis during 1988-1997.

CONCLUSIONS

Changes in treatment trends for USC over the last 2 decades have resulted in an improvement in outcome especially those with stage I-III disease.

摘要

目的

我们的研究使用监测、流行病学和最终结果数据库来确定过去20年中观察到的治疗模式变化是否改善了子宫浆液性癌（USC）患者的预后。

方法

使用监测、流行病学和最终结果数据库识别出1988年至2011年期间的USC女性患者（n = 8230），并将其分为3个队列（1988 - 1997年、1998 - 2004年和2005 - 2011年）。估计疾病特异性生存率和总生存率。使用Kaplan - Meier生存曲线和Cox回归模型。

结果

疾病特异性生存率（59个月对94个月对未达到；P < 0.001）和总生存率（31个月对37个月对45个月；P < 0.001）随时间改善。在单变量分析中，仅I - III期患者以及居住在西部或中部地区的患者随时间有改善。在多变量分析中，调整年龄、种族、婚姻状况、分期、地理位置、癌症相关手术、淋巴结清扫范围和辅助放疗后，与1988 - 1997年期间确诊的患者相比，2005年至2011年期间确诊的患者死于子宫癌的可能性降低22%（风险比[HR]，0.78；95%置信区间[CI]，0.70 - 0.87；P < 0.001），死于任何原因的可能性降低17%（HR，0.83；95% CI，0.76 - 0.90；P < 0.0001）。同样，与1988 - 1997年期间确诊的患者相比，1998 - 2004年期间确诊的患者死于子宫癌的可能性降低15%（HR，0.85；95% CI，0.77 - 0.94；P = 0.0015），死于任何原因的可能性降低10%（HR，0.90；95% CI，0.83 - 0.97；P = 0.0048）。