Key Laboratory of Gene Editing Screening and R&D of Digestive System Tumor Drugs, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Medicine (Baltimore). 2022 Sep 23;101(38):e30607. doi: 10.1097/MD.0000000000030607.
The objective for the study was to analysis the epidemiology of adenosarcoma, and independent prognostic factors and impact of lymph node dissection (LND) of uterine adenosarcoma. Cases of patients with primary adenosarcoma were obtained from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2016. Overall survival was analyzed by the Kaplan-Meier method and log-rank test. The differences in baseline covariates between the 2 groups were adjusted by inverse probability of treatment weighting method. The prognostic factors were identified by univariate and multivariate Cox regression analysis and hazard ratio and 95% confidence interval (CI) of covariates were also estimated. 1129 patients with pathological primary adenosarcoma between 2000 and 2016 were identified from the surveillance, epidemiology, and end results database. The only 4 patients were male. 1027 patients with primary uterine adenosarcoma, and 53.1% underwent LND and only 3.5% patients were with positive lymph node. Age, marital status, largest tumor size, tumor grade, T stage and chemotherapy were significantly correlated with survival. Race, tumor number, LND, and radiotherapy did not affect overall survival in patients. Inverse probability of treatment weighting-adjusted K-M curve showed that LND did not improve survival and lymph node metastasis (LNM) did not affect survival. The majority of primary adenosarcoma patients are female with high incidence of uterus and rare incidence of distant metastasis. Age, marital status, tumor size, T stage, grade, and chemotherapy are independent prognostic factors of uterine adenosarcoma. LNM was not a significant prognostic risk factor, and LND did not benefit survival.
本研究旨在分析子宫腺肉瘤的流行病学特征，以及独立的预后因素和淋巴结清扫（LND）对子宫腺肉瘤的影响。从 2000 年至 2016 年，从监测、流行病学和最终结果（SEER）数据库中获取了原发性腺肉瘤患者的病例。采用 Kaplan-Meier 方法和对数秩检验分析总生存率。通过逆概率处理权重法调整两组间基线协变量的差异。通过单因素和多因素 Cox 回归分析确定预后因素，并估计协变量的风险比和 95%置信区间（CI）。从监测、流行病学和最终结果数据库中确定了 2000 年至 2016 年间 1129 例病理原发性腺肉瘤患者。仅 4 例为男性。1027 例原发性子宫腺肉瘤患者中，53.1%行 LND，仅 3.5%患者淋巴结阳性。年龄、婚姻状况、最大肿瘤大小、肿瘤分级、T 分期和化疗与生存显著相关。种族、肿瘤数量、LND 和放疗对患者的总生存率没有影响。经过处理权重校正的 K-M 曲线表明，LND 并不能提高生存率，且淋巴结转移（LNM）并不影响生存。大多数原发性腺肉瘤患者为女性，子宫发病率高，远处转移率低。年龄、婚姻状况、肿瘤大小、T 分期、分级和化疗是子宫腺肉瘤的独立预后因素。LNM 不是显著的预后危险因素，LND 不能提高生存率。
