Feng Tie-Cheng, Zai Hong-Yan, Jiang Wei, Zhu Qin, Jiang Bo, Yao Lei, Li Xin-Ying, Wang Zhi-Ming
Department of Liver and Thyroid Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
Ann Transl Med. 2019 Oct;7(20):555. doi: 10.21037/atm.2019.09.76.
The goal of this study is to assess the newest survival of hepatoblastoma (HB) and the risk factors which impacted on survival by using the Surveillance, Epidemiology and End Results (SEER) database, also calculate the incidence of HB in recent years.
We calculate age-adjusted incidence of HB by using SEER 21 registries. Age, sex, race, tumor size, macrovascular involvement, multifocal tumor, distant metastasis, the way of treatment, and the survival were collected for survival and analysis of prognostic factors in SEER 18 registries. Survival curves, according to different factors, were obtained by Kaplan-Meier estimates. Multivariable Cox regression models were also built.
The overall age-adjusted incidence of HB was 0.19 patients per 100,000 children with a statistically significant increase per year. Overall survival (OS) at 1-, 3- and 5-year for all patients were 89.3%, 84.6%, and 81.9%, respectively. Multivariate analysis showed tumor size >5 cm [hazard ratio (HR), 8.271; 95% confidence interval (CI), 1.134-60.310], multiple tumors (HR, 2.578; 95% CI, 1.424-4.668) and no-surgery treatment (HR, 7.520; 95% CI, 4.121-13.724) were independent indicators of poor prognosis. Only the age ≥2-year-old (HR, 3.240; 95% CI, 1.433-7.326) and multiple tumors (HR, 2.395; 95% CI, 1.057-5.430) were the risk factors for the surgical treatment group.
The survival of patients with HB has been greatly improved in the recent years, and at the same time, due to the application of better chemotherapy, we should re-evaluate the traditional risk indicators of prognosis in order to better apply to the clinical.
本研究的目的是利用监测、流行病学和最终结果(SEER)数据库评估肝母细胞瘤(HB)的最新生存率以及影响生存率的危险因素,并计算近年来HB的发病率。
我们使用SEER 21个登记处的数据计算HB的年龄调整发病率。收集SEER 18个登记处中患者的年龄、性别、种族、肿瘤大小、大血管受累情况、多灶性肿瘤、远处转移、治疗方式及生存情况,以分析预后因素。根据不同因素,通过Kaplan-Meier估计法获得生存曲线。还构建了多变量Cox回归模型。
HB的总体年龄调整发病率为每10万名儿童中有0.19例患者,且每年有统计学显著增加。所有患者1年、3年和5年的总生存率(OS)分别为89.3%、84.6%和81.9%。多变量分析显示,肿瘤大小>5 cm[风险比(HR),8.271;95%置信区间(CI),1.134 - 60.310]、多灶性肿瘤(HR,2.578;95% CI,1.424 - 4.668)和未接受手术治疗(HR,7.520;95% CI,4.121 - 13.724)是预后不良的独立指标。仅年龄≥2岁(HR,3.240;95% CI,1.433 - 7.326)和多灶性肿瘤(HR,2.395;95% CI,1.057 - 5.