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肺转移瘤的流行病学

The Epidemiology of Lung Metastases.

作者信息

Chen Hanbo, Stoltzfus Kelsey C, Lehrer Eric J, Horn Samantha R, Siva Shankar, Trifiletti Daniel M, Meng Mao-Bin, Verma Vivek, Louie Alexander V, Zaorsky Nicholas G

机构信息

Department of Radiation Oncology, Amsterdam University Medical Centers, Amsterdam, Netherlands.

Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PA, United States.

出版信息

Front Med (Lausanne). 2021 Sep 20;8:723396. doi: 10.3389/fmed.2021.723396. eCollection 2021.

Abstract

Lung metastasis is usually associated with poor outcomes in cancer patients. This study was performed to characterize and analyze the population of patients with (synchronous) lung metastases using the Surveillance, Epidemiology and End Results (SEER) database. Baseline characteristics of lung metastasis patients were obtained from SEER case listings. Incidence rates and counts of synchronous lung metastasis were also obtained using the SEERStat software. Survival outcomes were analyzed using univariate and multivariable Cox regressions, controlling for confounders. An alpha threshold of 0.05 was used for statistical significance and -values were subject to correction for multiple comparisons. The age-adjusted incidence rate of synchronous lung metastasis was 17.92 per 100,000 between 2010 and 2015. Synchronous lung metastases most commonly arose from primary lung cancers, colorectal cancers, kidney cancers, pancreatic cancers and breast cancers. During this time period, 4% of all cancer cases presented with synchronous lung metastasis. The percentage of patients presenting with synchronous lung metastasis ranged from 0.5% of all prostate cancers to 13% of all primary lung cancers. The percentage of all cancer cases presenting with synchronous lung metastasis increased over time. metastatic patients with lung metastases had worse overall survival [hazard ratio = 1.22 (1.21-1.23), < 0.001] compared to those with only extrapulmonary metastases, controlling for potential confounders. Synchronous lung metastasis occurs frequently and is an independent predictors of poor patient outcomes. As treatment for lung metastases becomes more complicated, patients with synchronous lung metastasis represent a high-risk population.

摘要

肺转移通常与癌症患者的不良预后相关。本研究旨在使用监测、流行病学和最终结果(SEER)数据库对(同时性)肺转移患者群体进行特征描述和分析。肺转移患者的基线特征来自SEER病例清单。同时性肺转移的发病率和病例数也使用SEERStat软件获得。使用单变量和多变量Cox回归分析生存结果,并对混杂因素进行控制。统计显著性的α阈值设定为0.05,P值需进行多重比较校正。2010年至2015年期间,年龄调整后的同时性肺转移发病率为每10万人17.92例。同时性肺转移最常见于原发性肺癌、结直肠癌、肾癌、胰腺癌和乳腺癌。在此期间,所有癌症病例中有4%出现同时性肺转移。出现同时性肺转移的患者百分比范围从所有前列腺癌的0.5%到所有原发性肺癌的13%。所有出现同时性肺转移的癌症病例百分比随时间增加。与仅发生肺外转移的患者相比,发生肺转移的患者总体生存率更差[风险比 = 1.22(1.21 - 1.23),P < 0.001],同时对潜在混杂因素进行了控制。同时性肺转移经常发生,并且是患者不良预后的独立预测因素。随着肺转移治疗变得更加复杂,同时性肺转移患者代表了一个高危人群。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e233/8488106/467749463257/fmed-08-723396-g0001.jpg

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