性别对胃肠胰源性神经内分泌肿瘤治疗及预后的影响：一项单中心分析
Influence of Gender on Therapy and Outcome of Neuroendocrine Tumors of Gastroenteropancreatic Origin: A Single-Center Analysis.
作者信息
Mogl Martina T, Dobrindt Eva M, Buschermöhle Josephine, Bures Claudia, Pratschke Johann, Amthauer Holger, Wetz Christoph, Jann Henning
机构信息
Department of Surgery, Campus Charité Mitte, Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum and Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
出版信息
Visc Med. 2020 Feb;36(1):20-27. doi: 10.1159/000505500. Epub 2020 Jan 20.
INTRODUCTION
Gender-specific treatment is gaining growing attention in various fields of medicine. In gastrointestinal cancer, influence of sex on outcome has been discussed, while this has not been the case in neuroendocrine tumors. Overall, the incidence of neuroendocrine neoplasms is rising, especially for appendiceal neuroendocrine neoplasms in women. Also, women seem to have a slight advantage in response to therapy, especially for liver metastases.
OBJECTIVES
This single-center analysis aimed to investigate gender-specific differences in our cohort related to distribution, therapy, and outcome.
METHODS
Patients from the NET registry as well as the clinic database were evaluated retrospectively concerning overall survival and response to therapy with respect to gender. A subgroup analysis was carried out for patients with low grading and response to chemotherapy, as well as for patients with good and moderate grading receiving peptide receptor radionuclide therapy and for a group of patients with liver surgery.
RESULTS
No specific differences could be detected for overall survival or response to therapy between male and female patients. Mean survival was estimated with 242.2 months (±10.39 SD) altogether and 221.7 months (± 13.02 SD) for male patients and 253.5 months (±15.24 SD) for female patients from the NET registry from initial diagnosis. There was no significant difference between female and male patients ( = 0.136). For patients receiving chemotherapy, overall survival from initial diagnosis was calculated with 26 months (±2.59) and did not show any significant differences between female and male patients 24.8 months (±2.81 SD) vs. 27.8 months (±3.86 SD, = 0.87). Patients undergoing peptide receptor radionuclide therapy showed a median progression-free survival of 26.9 months (±2.82 SD), with 16.9 (±5.595 SD) and 26.9 months (±3.019 SD) for male and female patients, respectively ( = 0.2). In the group of patients with liver surgery, female patients reached an estimated overall survival of 64.7 months (±4.16 SD), male patients 65.1 months (±2.79 SD, = 0.562).
CONCLUSION
Our cohort did not reveal significant differences in outcome and response to therapy with regards to gender.
引言
性别特异性治疗在医学各个领域正受到越来越多的关注。在胃肠道癌中，性别对治疗结果的影响已得到讨论，而在神经内分泌肿瘤中情况并非如此。总体而言，神经内分泌肿瘤的发病率正在上升，尤其是女性阑尾神经内分泌肿瘤。此外，女性在治疗反应方面似乎略有优势，特别是对于肝转移患者。
目的
本单中心分析旨在研究我们队列中与分布、治疗和结果相关的性别特异性差异。
方法
对来自神经内分泌肿瘤登记处以及临床数据库的患者进行回顾性评估，比较其总体生存率和性别相关的治疗反应。对低分级和化疗反应患者、接受肽受体放射性核素治疗的高分级和中分级患者以及接受肝脏手术的患者进行亚组分析。
结果
男性和女性患者在总体生存率或治疗反应方面未发现特定差异。从初始诊断起，神经内分泌肿瘤登记处的患者总体平均生存时间估计为242.2个月（±10.39标准差）；男性患者为221.7个月（±13.02标准差），女性患者为253.5个月（±15.24标准差）。女性和男性患者之间无显著差异（P = 0.136）。接受化疗的患者，从初始诊断起的总体生存时间计算为26个月（±2.59），女性和男性患者之间无显著差异（24.8个月±2.81标准差 vs. 27.8个月±3.86标准差，P = 0.87）。接受肽受体放射性核素治疗的患者无进展生存期的中位数为26.9个月（±2.82标准差），男性患者为16.9个月（±5.595标准差），女性患者为26.9个月（±3.019标准差）（P = 0.2）。在接受肝脏手术的患者组中，女性患者的估计总体生存时间为64.7个月（±4.16标准差），男性患者为65.1个月（±2.79标准差，P = 0.562）。
结论
我们的队列未显示出在治疗结果和反应方面存在显著的性别差异。
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