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胰腺破骨细胞样巨细胞瘤与胰腺腺癌的临床特征和预后比较:一项基于人群的研究。

Clinical Characteristics and Prognosis of Osteoclast-like Giant Cell Tumors of the Pancreas Compared with Pancreatic Adenocarcinomas: A Population-Based Study.

机构信息

Cancer Center of Daping Hospital, Third Military Medical University, Chongqing, China (mainland).

Department of Orthopaedic Surgery, People's Hospital of Fengjie County, Chongqing, China (mainland).

出版信息

Med Sci Monit. 2020 Jul 27;26:e922585. doi: 10.12659/MSM.922585.

Abstract

BACKGROUND The incidence of osteoclast-like giant cell tumor of the pancreas (OGTP) is very low, and relatively little OGTP clinical data is available. The present study, therefore, sought to conduct a more comprehensive analysis of the clinical characteristics and prognosis of OGTP. MATERIAL AND METHODS A large population-based cohort analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) registry. We conducted a systematic assessment of the demographic and clinical characteristics of these patients, in addition to assessing available prognostic and therapeutic data corresponding to their disease. We further compared overall survival (OS) in these OGTP and pancreatic adenocarcinoma (PA) patient cohorts, adjusting for sex, grade, stage, and surgical treatment by propensity score matching (PSM). RESULTS We included a total of 47 OGTP patients and 73 150 PA patients in the present analysis. The mean ages of PA and OGTP diagnosis were 68.0 and 62.8 years, respectively. Compared with PA patients, OGTP patients were more likely to be female (70.2% versus 48.7%, P<0.01), to have early-stage disease, to have lower rates of lymph node metastasis (17.0% versus 28.8%, P<0.01) and distant metastasis (17.0% versus 45.1%, P<0.01), and to have higher rates of tumor resection (70.2% versus 15.4%, P<0.01). OGTP patients also had a significantly longer median OS than did PA patients (13 months versus 6 months; hazard ratio [HR] 0.55, 95% confidence interval [CI] 0.37-0.57, P<0.0001). No significant differences in tumor site preferences were detected. Our findings also suggested that being female, having early-stage disease, and undergoing surgical resection may be associated with a more favorable prognosis in patients with OGTP. CONCLUSIONS OGTP patients had distinctive clinical characteristics and a better prognosis compared with PA patients. Understanding these differences will help clinicians accurately recognize these diseases. Radical resection was beneficial to the survival of OGTP patients.

摘要

背景

胰腺破骨细胞样巨细胞瘤(OGTP)的发病率很低,相关的 OGTP 临床数据相对较少。本研究旨在更全面地分析 OGTP 的临床特征和预后。

材料和方法

本研究使用监测、流行病学和最终结果(SEER)数据库进行了一项大型基于人群的队列分析。我们对这些患者的人口统计学和临床特征进行了系统评估,此外还评估了与疾病相关的可用预后和治疗数据。我们进一步通过倾向评分匹配(PSM)比较了 OGTP 和胰腺腺癌(PA)患者队列的总生存率(OS),调整了性别、分级、分期和手术治疗因素。

结果

本研究共纳入 47 例 OGTP 患者和 73150 例 PA 患者。PA 和 OGTP 诊断的平均年龄分别为 68.0 岁和 62.8 岁。与 PA 患者相比,OGTP 患者更可能为女性(70.2%比 48.7%,P<0.01)、更可能处于早期疾病阶段、淋巴结转移率更低(17.0%比 28.8%,P<0.01)、远处转移率更低(17.0%比 45.1%,P<0.01)、肿瘤切除率更高(70.2%比 15.4%,P<0.01)。OGTP 患者的中位 OS 也明显长于 PA 患者(13 个月比 6 个月;风险比[HR]0.55,95%置信区间[CI]0.37-0.57,P<0.0001)。两组肿瘤部位偏好无明显差异。我们的研究结果还表明,女性、早期疾病和手术切除与 OGTP 患者的预后更有利相关。

结论

与 PA 患者相比,OGTP 患者具有独特的临床特征和更好的预后。了解这些差异将有助于临床医生准确识别这些疾病。根治性切除对 OGTP 患者的生存有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4abc/7409385/fe298cb350d4/medscimonit-26-e922585-g001.jpg

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