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WHO 分级 III 级胶质瘤的流行病学趋势、相对生存率和预后危险因素:一项基于人群的研究。

Epidemiological trends, relative survival, and prognosis risk factors of WHO Grade III gliomas: A population-based study.

机构信息

Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.

出版信息

Cancer Med. 2019 Jun;8(6):3286-3295. doi: 10.1002/cam4.2164. Epub 2019 Apr 24.

Abstract

BACKGROUND

Population-based studies on grade III gliomas are still lacking. The purpose of our study was to investigate epidemiological characteristics, survival, and risk factors of these tumors.

PATIENTS AND METHODS

All data of patients with grade III gliomas were extracted from the Surveillance, Epidemiology, and End Results database. This database provides analysis to evaluate age-adjusted incidence, incidence-based mortality, and limited-duration prevalence. The trends of incidence and mortality were modeled using Joinpoint program. Relative survival was also available in this database. Univariate and multivariate analyses were used to access the prognostic significance of risk factors on cancer-specific survival. Nomogram was constructed to predict 3-, 5-, and 10-year survival.

RESULTS

Our study showed that during 2000-2013, the incidence was stable and the mortality rate dropped significantly with APC as -1.95% (95% CI: -3.35% to -0.54%). Patients aged 40-59 had the highest prevalent cases. The 1-, 3-, 5-, and 10-year relative survival rates for all patients were 74.7%, 52.8%, 44.4%, and 32.4%. And it varied by risk factors. Cox regression analysis showed older age, male, black race, divorced status, histology of AA, tumor size <3.5 cm and no surgery were associated with worse survival.

CONCLUSION

Our study provides reasonable estimates of the incidence, mortality, and prevalence for patients with grade III gliomas during 2000-2013. The results of relative survival and Cox regression analysis revealed that age, race, sex, year of diagnosis, tumor site, histologic type, tumor size, and surgery were the identifiable prognostic indicators. The effects of radiotherapy still need further study. We integrated these risk factors to construct an effective clinical prediction model.

摘要

背景

目前仍缺乏关于 III 级胶质瘤的基于人群的研究。本研究旨在调查这些肿瘤的流行病学特征、生存情况和危险因素。

患者和方法

从监测、流行病学和最终结果数据库中提取所有 III 级胶质瘤患者的数据。该数据库提供了分析,以评估年龄调整后的发病率、发病率为基础的死亡率和有限持续时间的患病率。使用 Joinpoint 程序对发病率和死亡率的趋势进行建模。该数据库还提供了相对生存率。使用单变量和多变量分析来评估危险因素对癌症特异性生存率的预后意义。构建列线图以预测 3、5 和 10 年生存率。

结果

我们的研究表明,2000-2013 年间,发病率保持稳定,死亡率呈显著下降趋势,APC 为-1.95%(95%CI:-3.35%至-0.54%)。40-59 岁的患者有最高的发病例数。所有患者的 1 年、3 年、5 年和 10 年相对生存率分别为 74.7%、52.8%、44.4%和 32.4%。这因危险因素而异。Cox 回归分析显示,年龄较大、男性、黑人、离婚、组织学为 AA、肿瘤大小<3.5cm 和未手术与较差的生存相关。

结论

我们的研究提供了 2000-2013 年 III 级胶质瘤患者发病率、死亡率和患病率的合理估计。相对生存率和 Cox 回归分析的结果表明,年龄、种族、性别、诊断年份、肿瘤部位、组织学类型、肿瘤大小和手术是可识别的预后指标。放疗的影响仍需进一步研究。我们整合了这些危险因素,构建了一个有效的临床预测模型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/75fd/6558496/4e84674f6e9a/CAM4-8-3286-g001.jpg

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