Patel Mausam, Im Jay, Ivy Austin, Maraboyina Sanjay, Kim Thomas
Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 West Markham St, Slot 771, Little Rock, AR, 72205, USA.
Int Urol Nephrol. 2020 Jan;52(1):51-57. doi: 10.1007/s11255-019-02289-w. Epub 2019 Sep 25.
To perform a retrospective analysis of the epidemiology and role of surgery on survival in patients with urethral clear cell carcinoma (UCCC) using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database.
UCCC cases diagnosed from January 1, 1973, to December 31, 2014, were extracted from SEER. Descriptive statistics were calculated for all variables. Univariate analysis to assess for differences in survival with respect to covariates was performed using the log-rank test. Multivariate analysis was performed with Cox proportional hazards regression models to determine the predictive performance of covariates with respect to overall survival (OS) and disease-specific survival (DSS), reported as hazard ratio (HR) with 95% CIs. Comparisons were considered statistically significant at P < 0.05.
Sixty-one cases were extracted for analysis. Mean age ± SD was 63.0 ± 13.9 years. Fifty (82%), 18 (29.5%), and 14 (23.0%) patients underwent surgery, radiation, and chemotherapy, respectively. On univariate analysis, the following covariates were associated with both OS and DSS: age, stage, and surgery (all P < 0.001). On multivariate analysis, surgery was a predictor for improved OS and DSS (HR, 0.178; 95% CI [0.068; 0.464]) and HR, 0.166; 95% CI [0.057; 0.484], respectively). Neither radiation nor chemotherapy was significantly associated with OS or DSS.
Surgery was associated with improved OS and DSS in patients with UCCC. While neither radiation nor chemotherapy was significantly associated with survival, additional studies are necessary to determine how these therapeutic interventions may impact prognosis.
利用美国国立癌症研究所的监测、流行病学和最终结果（SEER）数据库，对尿道透明细胞癌（UCCC）患者的流行病学及手术对生存的作用进行回顾性分析。
从SEER数据库中提取1973年1月1日至2014年12月31日诊断的UCCC病例。对所有变量进行描述性统计。使用对数秩检验进行单因素分析，以评估协变量在生存方面的差异。采用Cox比例风险回归模型进行多因素分析，以确定协变量对总生存（OS）和疾病特异性生存（DSS）的预测性能，结果以风险比（HR）及95%置信区间（CI）表示。P < 0.05时认为差异具有统计学意义。
共提取61例病例进行分析。平均年龄±标准差为63.0±13.9岁。分别有50例（82%）、18例（29.5%）和14例（23.0%）患者接受了手术、放疗和化疗。单因素分析显示，以下协变量与OS和DSS均相关：年龄、分期和手术（均P < 0.001）。多因素分析显示，手术是OS和DSS改善的预测因素（HR分别为0.178；95%CI[0.068；0.464]）和HR为0.166；95%CI[0.057；0.484]）。放疗和化疗均与OS或DSS无显著相关性。
手术与UCCC患者的OS和DSS改善相关。虽然放疗和化疗均与生存无显著相关性，但仍需进一步研究以确定这些治疗干预措施如何影响预后。
