乳腺外佩吉特病治疗方案的预后价值：一项监测、流行病学和最终结果（SEER）数据库分析

Prognostic value of treatment options for extramammary Paget's disease: a SEER database analysis.

作者信息

Ma Xiaobo, Li Yongfeng

机构信息

Department of General Surgery, the First Hospital of Shanxi Medical University, Taiyuan, China.

Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Transl Cancer Res. 2021 Jun;10(6):2873-2881. doi: 10.21037/tcr-20-3492.

DOI:10.21037/tcr-20-3492

PMID:35116597

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8798862/

Abstract

BACKGROUND

Extramammary Paget's disease (EMPD) is a common subtype of Paget's disease. Still, there are lacking reports concerning its clinical features, treatment options, and prognosis.

METHODS

The Surveillance, Epidemiology, and End Results (SEER) database was queried for the patients diagnosed with mammary Paget's disease (MPD) or EMPD from 1975 to 2016. Subsequent analysis was conducted to explore incidence rate, tumor characteristics, clinical features, and survival.

RESULTS

A total of 1,848 patients with EMPD and 7,106 patients with MPD were retrieved from the SEER database and included in this study. The demographics of EMPD and MPD were significantly different. Compared with MPD, EMPD had better cancer-specific survival (CSS) but worse overall survival (OS). For EMPD, age (P<0.001), male (P=0.006), chemotherapy (P=0.002), poorly differentiated and undifferentiated grade (both P<0.001) and tumor metastasis (regional: P=0.019; distant: P<0.001) were independent negative prognostic indicators. Survival analysis revealed that surgery could improve both CSS and OS for EMPD (both P<0.001). However, neither radiotherapy (P=0.013 and P<0.001) nor chemotherapy (P=0.007 and P<0.001) did not exhibit favorable prognostic benefit.

CONCLUSIONS

EMPD had distinct clinical features from MPD. Age, gender, chemotherapy, tumor grade and stage are independent prognostic factors for EMPD. While surgery's protective role was supported, radiotherapy and chemotherapy could be unfavorable treatments concerning EMPD prognosis.

摘要

背景

乳腺外佩吉特病（EMPD）是佩吉特病的一种常见亚型。然而，关于其临床特征、治疗选择和预后的报道仍然较少。

方法

查询监测、流行病学和最终结果（SEER）数据库，以获取1975年至2016年期间诊断为乳腺佩吉特病（MPD）或EMPD的患者。随后进行分析，以探讨发病率、肿瘤特征、临床特征和生存率。

结果

从SEER数据库中检索出1848例EMPD患者和7106例MPD患者，并纳入本研究。EMPD和MPD的人口统计学特征存在显著差异。与MPD相比，EMPD具有更好的癌症特异性生存率（CSS），但总体生存率（OS）较差。对于EMPD，年龄（P<0.001）、男性（P=0.006）、化疗（P=0.002）、低分化和未分化分级（均P<0.001）以及肿瘤转移（区域：P=0.019；远处：P<0.001）是独立的负面预后指标。生存分析显示，手术可以改善EMPD的CSS和OS（均P<0.001）。然而，放疗（P=0.013和P<0.001）和化疗（P=0.007和P<0.001）均未显示出良好的预后益处。