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基于 SEER 数据库的 99922 例胃癌生存的性别差异。

Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database.

机构信息

Dermatovenerology Digestive Medicine Center, The Seventh Affiliated Hospital of Sun Yat-Sen University, No. 628, Zhenyuan Rd, Guangming (New) Dist., Shenzhen, China.

Department of Gastrointestinopancreatic Surgery, The First Affiliated Hospital of Sun Yat-Sen University, 58 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, People's Republic of China.

出版信息

J Gastrointest Surg. 2020 Aug;24(8):1747-1757. doi: 10.1007/s11605-019-04304-y. Epub 2019 Jul 25.

Abstract

OBJECTIVES

To evaluate gender differences in initial presentation, pathology and outcomes with GC (GC).

METHODS

The 1973-2013 Surveillance Epidemiology and End Results (SEER) 17-registry database was analysed for renal tumours from 1973 to 2013 coded as primary site "stomach". After various exclusions, a final study group of 99,922 cases with complete data was obtained. Demographic variables analysed included age, sex, marital status and race. Tumour variables included size, stage at diagnosis, grade, primary site, treatment and histology. Primary outcome variables included overall survival (OS) and cancer-specific survival (CSS).

RESULTS

Overall, 96,501 gastric cancer patients were identified. Of those, 34,862 (36.2%) were women. For woman, log-rank test showed that OS and CSS were significantly longer in man (p < 0.0001). In Cox regression analysis, woman was associated with a significantly improved OS [(HR of death in 1973 to 2003 = 0.87, 95% CI = 0.85-0.89, P < 0.001) (HR of death in 2004 to 2013 = 0.94, 95% CI = 0.91-0.97, P < 0.001)] and cancer-specific survival [(HR of death in 1973 to 2003 = 0.90, 95% CI = 0.87-0.92, P < 0.001) (HR of death in 2004 to 2013 = 0.90, 95% CI = 0.87-0.93, P < 0.001)]. When performing a Kaplan-Meier curve analysis after propensity score matching, gender persisted to be a significant survival of woman for OS and CSS.

CONCLUSIONS

Men present with larger, higher stage, higher grade GC than women. OS and CSS are better in women, which is significantly different.

摘要

目的

评估 GC(胃泌素瘤)患者初始表现、病理和结局的性别差异。

方法

对 1973 年至 2013 年监测、流行病学和最终结果(SEER)17 登记数据库进行了分析,该数据库对 1973 年至 2013 年编码为原发性“胃”部位的肾肿瘤进行了分析。经过各种排除后,获得了最终的 99922 例具有完整数据的研究组。分析的人口统计学变量包括年龄、性别、婚姻状况和种族。肿瘤变量包括大小、诊断时的分期、分级、原发性部位、治疗和组织学。主要结局变量包括总生存率(OS)和癌症特异性生存率(CSS)。

结果

总体而言,确定了 96501 例胃癌患者。其中,34862 例(36.2%)为女性。对于女性,对数秩检验显示男性的 OS 和 CSS 明显更长(p<0.0001)。在 Cox 回归分析中,女性与 OS 显著改善相关[(1973 年至 2003 年死亡的 HR 为 0.87,95%CI=0.85-0.89,P<0.001)(2004 年至 2013 年死亡的 HR 为 0.94,95%CI=0.91-0.97,P<0.001)]和癌症特异性生存率[(1973 年至 2003 年死亡的 HR 为 0.90,95%CI=0.87-0.92,P<0.001)(2004 年至 2013 年死亡的 HR 为 0.90,95%CI=0.87-0.93,P<0.001)]。在进行倾向评分匹配后的 Kaplan-Meier 曲线分析后,性别仍然是 OS 和 CSS 女性生存的重要因素。

结论

男性比女性表现出更大、更高分期、更高分级的 GC。女性的 OS 和 CSS 更好,这有显著差异。

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