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不同转移性部位对手术治疗后 FIGO 分期为 IVB 期子宫内膜癌患者预后的预测价值:SEER 数据库分析。

Prognostic value of different metastatic sites for patients with FIGO stage IVB endometrial cancer after surgery: A SEER database analysis.

机构信息

Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Surg Oncol. 2020 Oct;122(5):941-948. doi: 10.1002/jso.26102. Epub 2020 Jul 18.

Abstract

OBJECTIVE

This study aimed to investigate the association between different metastatic sites and survival in endometrial cancer (EC) patients with International Federation of Gynecology and Obstetrics (FIGO) stage IVB disease.

METHODS

FIGO stage IVB patients with EC were selected from the surveillance, epidemiology, and end results database. Overall survival (OS) and cause-specific survival (CSS) were analyzed with Kaplan-Meier analysis and log-rank tests. Univariate and multivariate Cox proportional hazard models were used to identify the prognostic factors for OS and CSS.

RESULTS

A total of 929 FIGO stage IVB patients with EC were identified. Patients with peritoneum metastasis were associated with significantly better OS and CSS compared to those with organ-specific metastasis (median OS: 29 vs 19 months, P = .005; median CSS: 47 vs 25 months, P < .001). Moreover, the survival superiority of peritoneum metastasis remained significant when organ-specific metastasis was further classified into specific single-organ metastasis. The multivariate analysis also indicated that compared with peritoneum metastasis, bone, brain, and lung metastasis were independent prognostic factors for worse OS. Similarly, distant lymph node, bone, brain, liver, and lung metastasis were associated with worse CSS.

CONCLUSION

Metastatic sites affected prognosis in FIGO stage IVB patients with EC. Patients with peritoneum metastasis had significantly better survival outcomes than those with organ-specific metastasis.

摘要

目的

本研究旨在探讨国际妇产科联合会(FIGO)分期为 IVB 期的子宫内膜癌(EC)患者中不同转移部位与生存的关系。

方法

从监测、流行病学和最终结果数据库中选择 FIGO 分期为 IVB 期的 EC 患者。采用 Kaplan-Meier 分析和对数秩检验分析总生存期(OS)和特异性生存期(CSS)。采用单因素和多因素 Cox 比例风险模型确定 OS 和 CSS 的预后因素。

结果

共确定了 929 例 FIGO 分期为 IVB 期的 EC 患者。与有特定器官转移的患者相比,腹膜转移患者的 OS 和 CSS 显著更好(中位 OS:29 个月比 19 个月,P = .005;中位 CSS:47 个月比 25 个月,P < .001)。此外,当将特定器官转移进一步分类为特定的单一器官转移时,腹膜转移的生存优势仍然显著。多因素分析还表明,与腹膜转移相比,骨、脑、肺转移是 OS 较差的独立预后因素。同样,远处淋巴结、骨、脑、肝和肺转移与 CSS 较差相关。

结论

转移部位影响 FIGO 分期为 IVB 期的 EC 患者的预后。腹膜转移患者的生存结果明显优于特定器官转移患者。

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