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按年龄分层的透明细胞肾细胞癌患者的预后:一项基于监测、流行病学和最终结果(SEER)数据库的研究

Prognosis of clear cell renal cell carcinoma patients stratified by age: A research relied on SEER database.

作者信息

Liao Zhouning, Wang Dang, Song Ning, Xu Yang, Ge Heming, Peng Zhangzhe

机构信息

Department of Nephrology, Xiangya Hospital, Central South University, Changsha, China.

Department of General Surgery, Xiangya Hospital, Central South University, Changsha, China.

出版信息

Front Oncol. 2022 Oct 12;12:975779. doi: 10.3389/fonc.2022.975779. eCollection 2022.

Abstract

OBJECTIVE

Clear cell renal cell carcinoma may affect patients of any age. To date, there are only a limited number of large data studies on renal clear cell carcinoma in different age groups. This study assessed CCRCC risk factors in different age groups using the Surveillance Epidemiology and End Results (SEER) database.

METHODS

We selected 58372 cases from the SEER database. These patients were divided into seven different age groups. Cox regression models were used to find independent risk factors for the survival of CCRCC patients. Based on independent risk factors, a nomogram was drawn with R software. Kaplan-Meier method for survival analysis and X-tile software were used to find the optimal age group for diagnosis.

RESULTS

Univariate analysis revealed that patients' age, sex, race, marital status, grade, TNM (tumor, node, metastasis) stage, surgery, WHO/ISUP grade were correlated with survival (P<0.01). Age was an independent risk factor for survival in patients with CCRCC according to multivariate Cox regression analysis (p<0.01). All-cause mortality and tumor-specific mortality increased according to the increasing age of the patients. The optimal cut-off values for age were defined as 58 and 76 years and 51 and 76 years, respectively, according to overall survival (OS) and cause-specific survival (CSS).

CONCLUSION

There is a negative correlation between age and survival of CCRCC patients. The difference in prognosis of patients in different age groups has important implications for clinical treatment. Therefore, the diagnosis and treatment plan should be based on more detailed age grouping, which is more beneficial to improving the prognosis and survival of patients.

摘要

目的

透明细胞肾细胞癌可影响任何年龄段的患者。迄今为止,针对不同年龄组肾透明细胞癌的大数据研究数量有限。本研究使用监测、流行病学与最终结果(SEER)数据库评估不同年龄组的透明细胞肾细胞癌(CCRCC)危险因素。

方法

我们从SEER数据库中选取了58372例病例。这些患者被分为七个不同的年龄组。使用Cox回归模型来寻找CCRCC患者生存的独立危险因素。基于独立危险因素,用R软件绘制了列线图。采用Kaplan-Meier生存分析方法和X-tile软件来确定诊断的最佳年龄组。

结果

单因素分析显示,患者的年龄、性别、种族、婚姻状况、分级、TNM(肿瘤、淋巴结、转移)分期、手术、世界卫生组织/国际泌尿病理学会(WHO/ISUP)分级与生存相关(P<0.01)。根据多因素Cox回归分析,年龄是CCRCC患者生存的独立危险因素(p<0.01)。全因死亡率和肿瘤特异性死亡率随患者年龄增加而升高。根据总生存期(OS)和病因特异性生存期(CSS),年龄的最佳截断值分别定义为58岁和76岁以及51岁和76岁。

结论

CCRCC患者的年龄与生存呈负相关。不同年龄组患者的预后差异对临床治疗具有重要意义。因此,诊断和治疗方案应基于更详细的年龄分组,这更有利于改善患者的预后和生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11e5/9597499/fcf95ba5a955/fonc-12-975779-g001.jpg

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