Liu Qiu-Yan, Xie Ling, Yang Xiao-Yun, Yang Lei, Lei Xiao-Lin
Department of Oncology, Affiliated Hospital of Panzhihua University, Panzhihua, Sichuan, China.
Int J Colorectal Dis. 2022 Nov;37(11):2397-2407. doi: 10.1007/s00384-022-04266-9. Epub 2022 Oct 27.
Small intestine adenocarcinoma (SIA) is a scant disease that has no adequate clinical trials, so its prognostic factors are still unclear, especially in elderly patients. In this article, we aimed to explore the clinicopathology presentation, treatments, outcomes, and predictors of small intestine adenocarcinoma patients aged 65 years or older.
We retrieved clinicopathology data of small intestine adenocarcinoma patients diagnosed between 2004 and 2015 from the Surveillance Epidemiology and End Results (SEER) database. We clarified patients into two groups: the surgery and the non-surgery group and conducted propensity score matching (PSM) to compare survival outcoming. We identified the prognostic indicators for cancer-specific survival (CSS) and overall survival (OS) by the Cox proportional hazards model.
In total, 1018 eligible cases were enrolled, with a median survival of 16 months; the 3-year OS and CSS rates were 36% and 41.7%, and the 5-year OS and CSS rates were 26.5% and 33.3%. Multivariate analyses revealed that age, grade, tumor stage, surgery, and chemotherapy were independent prognostic factors for OS, while grade, tumor stage, surgery, radiation, and chemotherapy were independent factors for CSS. After PSM, only surgery and tumor stage (AJCC 6th) were independent prognostic factors for OS and CSS.
Surgery could bring benefit to survival for elderly SIA patients, and the early stage of the disease was another significant prognostic factor.
小肠腺癌(SIA)是一种罕见疾病,尚无足够的临床试验,因此其预后因素仍不明确,尤其是在老年患者中。在本文中,我们旨在探讨65岁及以上小肠腺癌患者的临床病理表现、治疗方法、预后及预测因素。
我们从监测、流行病学和最终结果(SEER)数据库中检索了2004年至2015年间诊断为小肠腺癌患者的临床病理数据。我们将患者分为两组:手术组和非手术组,并进行倾向评分匹配(PSM)以比较生存结果。我们通过Cox比例风险模型确定癌症特异性生存(CSS)和总生存(OS)的预后指标。
总共纳入了1018例符合条件的病例,中位生存期为16个月;3年OS率和CSS率分别为36%和41.7%,5年OS率和CSS率分别为26.5%和33.3%。多因素分析显示,年龄、分级、肿瘤分期、手术和化疗是OS的独立预后因素,而分级、肿瘤分期、手术、放疗和化疗是CSS的独立因素。PSM后,只有手术和肿瘤分期(AJCC第6版)是OS和CSS的独立预后因素。
手术可为老年SIA患者的生存带来益处,疾病的早期阶段是另一个重要的预后因素。