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转移部位与转移灶数量对新诊断宫颈癌器官转移患者生存的影响。

Impact of sites versus number of metastases on survival of patients with organ metastasis from newly diagnosed cervical cancer.

作者信息

Yin Zhuomin, Tang Huarong, Li Li, Ni Juan, Yuan Shuhui, Lou Hanmei, Chen Ming

机构信息

Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou 310022, People's Republic of China.

Department of Radiation Oncology (Zhejiang Key Laboratory of Radiation Oncology), Zhejiang Cancer Hospital, Hangzhou 310022, People's Republic of China.

出版信息

Cancer Manag Res. 2019 Aug 16;11:7759-7766. doi: 10.2147/CMAR.S203037. eCollection 2019.

Abstract

OBJECTIVE

The aim of this study was to investigate the potential associations of the sites and the number of specific metastases with survival in patients newly diagnosed with cervical cancer.

METHODS

Medical records of patients with organ metastases of newly diagnosed cervical cancer at Zhejiang Cancer Hospital from October 2006 to December 2016 were reviewed retrospectively. Survival times were compared using the Kaplan-Meier method. Variables associated with survival were identified using univariate and multivariate Cox proportional hazards models.

RESULTS

A total of 99 patients with newly diagnosed organ metastatic cervical cancer were identified. Median follow-up was 11.6 months (range, 0.5-114.7 months). Median overall survival (OS) time was 11.7 months from diagnosis, with 1, 2, and 5-year OS rates of 48.2%, 22.8%, and 12.6%, respectively. The most common site of organ metastasis was bone (36.8%), followed by lung (32.8%) and liver (24%). In univariate analysis, OS rates were better for bone metastasis than visceral metastasis (=0.013), oligometastasis than non-oligometastasis (=0.003) and single organ metastasis than multiple organ metastases (=0.016), while that for liver metastasis was poorer than non-liver metastases (<0.001). In multivariate analysis, liver metastasis (hazard ratio [HR] =4.02; 95% confidence interval [CI], 1.15-14.05, =0.029) was significantly and independently related to poor overall survival.

CONCLUSION

Our data revealed the site of metastasis is associated with overall survival of patients with newly diagnosed organ metastatic cervical cancer, with liver metastasis signifying particularly poor overall survival. Individualized treatments should be administered to patients depending on the specific metastatic sites.

摘要

目的

本研究旨在探讨新诊断宫颈癌患者特定转移部位及转移灶数量与生存之间的潜在关联。

方法

回顾性分析2006年10月至2016年12月在浙江省肿瘤医院新诊断为器官转移的宫颈癌患者的病历。采用Kaplan-Meier法比较生存时间。使用单因素和多因素Cox比例风险模型确定与生存相关的变量。

结果

共纳入99例新诊断为器官转移的宫颈癌患者。中位随访时间为11.6个月(范围0.5 - 114.7个月)。自诊断起的中位总生存(OS)时间为11.7个月,1年、2年和5年OS率分别为48.2%、22.8%和12.6%。器官转移最常见的部位是骨(36.8%),其次是肺(32.8%)和肝(24%)。单因素分析中,骨转移患者的OS率优于内脏转移(P = 0.013),寡转移优于非寡转移(P = 0.003),单器官转移优于多器官转移(P = 0.016),而肝转移患者的OS率低于非肝转移患者(P < 0.001)。多因素分析中,肝转移(风险比[HR]=4.02;95%置信区间[CI],1.15 - 14.05,P = 0.029)与总生存不良显著且独立相关。

结论

我们的数据显示转移部位与新诊断为器官转移的宫颈癌患者的总生存相关,肝转移提示总生存尤其差。应根据特定的转移部位对患者进行个体化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c3/6701644/22197d17ba1b/CMAR-11-7759-g0001.jpg

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