Department of Urology, Stanford University Medical Center, Stanford, California, USA.
Can J Urol. 2021 Feb;28(1):10522-10529.
INTRODUCTION We sought to describe clinical characteristics and identify prognostic factors among patients with primary malignancies of the epididymis (PMEs).
The Surveillance, Epidemiology, and End Results (SEER) database (1975-2015) was queried to identify patients with PME. Descriptive statistics and multivariable Cox proportional hazards models were used.
Eighty-nine patients with PME were identified. Median age was 57 years (5-85), and median overall survival (OS) was 16.8 years. The most commonly represented histologies were rhabdomyosarcoma (19.1%), B-cell lymphoma (16.9%), leiomyosarcoma (16.9%), and liposarcoma (12.4%). In multivariable analysis, tumor size ≥ 4 cm was associated with worse OS (HR = 4.46, p = 0.01) compared to tumors < 4 cm. Patients with nonsarcomatoid histology had OS similar to patients with sarcomatoid histology (HR = 0.95, p = 0.92). Disease with regional invasion (HR = 5.19, p = 0.007) and distant metastasis (HR = 29.80, p = 0.0002) had worse OS compared to localized disease. Receipt of radiotherapy was associated with enhanced OS (HR = 0.10, p = 0.006), whereas receipt of chemotherapy was not associated with OS.
We describe the largest cohort of PMEs to date. Larger lesions and tumor stage were independently associated with poor overall survival, while receipt of radiotherapy was associated with enhanced overall survival.
介绍 我们旨在描述原发性附睾肿瘤(PMEs)患者的临床特征,并确定其预后因素。
通过监测、流行病学和最终结果(SEER)数据库(1975-2015 年),我们确定了患有 PME 的患者。采用描述性统计和多变量 Cox 比例风险模型进行分析。
共确定了 89 例 PME 患者。中位年龄为 57 岁(5-85 岁),中位总生存期(OS)为 16.8 年。最常见的组织学类型为横纹肌肉瘤(19.1%)、B 细胞淋巴瘤(16.9%)、平滑肌肉瘤(16.9%)和脂肪肉瘤(12.4%)。多变量分析显示,肿瘤大小≥4cm 与较差的 OS 相关(HR=4.46,p=0.01),而肿瘤大小<4cm 则与 OS 无关。非肉瘤样组织学患者的 OS 与肉瘤样组织学患者相似(HR=0.95,p=0.92)。有区域侵犯(HR=5.19,p=0.007)和远处转移(HR=29.80,p=0.0002)的疾病患者 OS 较差,而局限性疾病患者 OS 较好。放疗的应用与提高 OS 相关(HR=0.10,p=0.006),而化疗的应用与 OS 无关。
我们描述了迄今为止最大的 PME 队列。较大的病变和肿瘤分期与总体生存不良独立相关,而放疗的应用与总体生存的提高相关。