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热消融治疗肺类癌肿瘤的临床疗效:倾向评分匹配分析。

Clinical efficacy of thermal ablation for the treatment of pulmonary carcinoid tumor: a propensity-matched analysis.

机构信息

Department of Internal Medicine, Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China.

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Int J Hyperthermia. 2023;40(1):2225817. doi: 10.1080/02656736.2023.2225817.

Abstract

OBJECTIVE

To investigate the clinical efficacy of thermal ablation in the treatment of pulmonary carcinoid (PC) tumor.

METHODS

Data of patients with inoperable PC diagnosed from 2000 to 2019 were obtained from the SEER database and analyzed according to different therapeutic modality: thermal ablation vs non-ablation. Propensity score matching (PSM) was used to reduce intergroup differences. Kaplan-Meier curves and the log-rank test were used to compare intergroup differences of overall survival (OS) and lung cancer-specific survival (LCSS). Cox proportional risk models were used to reveal prognostic factors.

RESULTS

After PSM, the thermal ablation group had better OS ( < .001) and LCSS ( < .001) than the non-ablation group. Subgroup analysis stratified by age, sex, histologic type and lymph node status subgroups showed similar survival profile. In the subgroup analysis stratified by tumor size, the thermal ablation group showed better OS and LCSS than those of the non-ablation group for tumors ≤3.0 cm, not statistically significant for tumors >3.0 cm. Subgroup analysis by M stage showed that thermal ablation was superior to non-ablation in OS and LCSS for patients with M0 stage, but no significant difference was found in subgroups with distant metastatic disease. Multivariate analysis showed that thermal ablation was an independent prognostic factor for OS (HR: 0.34, 95% CI: 0.25-0.46,  < .001) and LCSS (HR: 0.23, 95%CI: 0.12-0.43,  < .001).

CONCLUSION

For patients with inoperable PC, thermal ablation might be a potential treatment option, especially in M0-stage with tumor size ≤3 cm.

摘要

目的

探讨热消融治疗肺类癌(PC)肿瘤的临床疗效。

方法

从 SEER 数据库中获取 2000 年至 2019 年期间诊断为不可手术的 PC 患者的数据,并根据不同的治疗方式(热消融与非消融)进行分析。采用倾向评分匹配(PSM)来减少组间差异。采用 Kaplan-Meier 曲线和对数秩检验比较总生存期(OS)和肺癌特异性生存期(LCSS)的组间差异。采用 Cox 比例风险模型揭示预后因素。

结果

PSM 后,热消融组的 OS( < .001)和 LCSS( < .001)均优于非消融组。按年龄、性别、组织学类型和淋巴结状态亚组分层的亚组分析显示出相似的生存模式。在按肿瘤大小分层的亚组分析中,对于肿瘤≤3.0cm 的患者,热消融组的 OS 和 LCSS 均优于非消融组,但对于肿瘤>3.0cm 的患者,差异无统计学意义。M 分期亚组分析显示,热消融在 OS 和 LCSS 方面优于非消融,对于 M0 期患者,但在远处转移疾病亚组中未发现显著差异。多因素分析显示,热消融是 OS(HR:0.34,95%CI:0.25-0.46, < .001)和 LCSS(HR:0.23,95%CI:0.12-0.43, < .001)的独立预后因素。

结论

对于不可手术的 PC 患者,热消融可能是一种潜在的治疗选择,特别是在肿瘤大小≤3cm 的 M0 期患者。

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