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美国 1975-2016 年间 11 个不同原发肿瘤部位的肺外小细胞癌的临床特征和生存情况。

Clinical characteristics and survival of extrapulmonary small cell carcinoma in 11 different primary tumor sites in the United States, 1975-2016.

机构信息

The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, P.R. China.

Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, P.R. China.

出版信息

Curr Med Res Opin. 2021 Jan;37(1):71-81. doi: 10.1080/03007995.2020.1846024. Epub 2020 Nov 23.

Abstract

OBJECTIVE

Few studies have investigated extrapulmonary small cell carcinoma (EPSCC) in a systematic way. This study is to analyze EPSCC in 11 tumor sites from different aspects in the United States (1975-2016).

METHODS

In total 4397 patients diagnosed with EPSCC in 11 primary tumor locations were selected from the Surveillance, Epidemiology and End Results (SEER) database. The incidence of EPSCC in the last decade, and the 1, 3 and 5 year survival rates of each tumor site were also roughly calculated. Prognostic factors of EPSCC were investigated by Cox regression analysis.

RESULTS

Statistically, the incidence of EPSCC was on the rise over the past 30 years. Of its 11 primary tumor sites, bladder was the most frequently affected while the stomach and kidney were rarely affected. Males were more susceptible to EPSCC than females. Married patients were more commonly afflicted by EPSCC, but had longer survival. Cases were most intensive in California and an increased trend had been observed. The 5 year overall survival (OS) rate ranged from 2.0% to 42.5% in patients with EPSCC in 11 tumor sites ( < .001). The OS was better for EPSCC in the breast and cervix. However, tumor sites in the colon, esophagus, pancreas, rectum and stomach were all associated with worse survival. Characteristics and prognosis of EPSCC in different tumor sites were statistically significant ( < .001). Age, gender, marital status, stage, surgery, radiotherapy and chemotherapy were equally significant factors of survival of EPSCC patients ( < .05).

CONCLUSION

There was an increasing trend of EPSCC incidence. The survival of EPSCC in different tumor sites was significantly different. Tumor locations, age, gender, marital status, stage, surgery, radiotherapy and chemotherapy were all important factors of survival. This study has implications for EPSCC prevention and treatment.

摘要

目的

很少有研究系统地研究肺外小细胞癌(EPSCC)。本研究旨在分析美国 11 个肿瘤部位的 EPSCC,从不同方面进行分析(1975-2016 年)。

方法

从监测、流行病学和最终结果(SEER)数据库中选择了 11 个原发肿瘤部位诊断为 EPSCC 的 4397 例患者。还大致计算了过去十年中 EPSCC 的发病率,以及每个肿瘤部位的 1、3 和 5 年生存率。通过 Cox 回归分析研究了 EPSCC 的预后因素。

结果

从统计学上看,过去 30 年来,EPSCC 的发病率呈上升趋势。在其 11 个原发肿瘤部位中,膀胱最常受累,而胃和肾很少受累。男性比女性更容易患 EPSCC。已婚患者更容易患 EPSCC,但生存时间更长。病例最集中在加利福尼亚州,且呈上升趋势。在 11 个肿瘤部位的 EPSCC 患者中,5 年总生存率(OS)从 2.0%到 42.5%不等( < .001)。在乳房和子宫颈中,EPSCC 的 OS 更好。然而,结肠、食管、胰腺、直肠和胃的肿瘤部位均与生存率较差相关。不同肿瘤部位的 EPSCC 的特征和预后差异有统计学意义( < .001)。年龄、性别、婚姻状况、分期、手术、放疗和化疗均是影响 EPSCC 患者生存的重要因素( < .05)。

结论

EPSCC 的发病率呈上升趋势。不同肿瘤部位的 EPSCC 生存率存在显著差异。肿瘤部位、年龄、性别、婚姻状况、分期、手术、放疗和化疗均是生存的重要因素。本研究对 EPSCC 的预防和治疗具有重要意义。

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