Department of Thoracic Surgery, Suzhou Wuzhong People's Hospital, Suzhou, Jiangsu Province, 215128, P. R. China.
Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, 215006, P. R. China.
J Cardiothorac Surg. 2023 Jul 10;18(1):224. doi: 10.1186/s13019-023-02340-z.
This study aimed to explore the survival significance of surgery and age on the prognosis of patients with primary trachea malignancies.
The entire cohort of 637 patients with primary malignant trachea tumors was used to perform the main analyses. The data of those patients were from a public database. Overall survival (OS) curves were drawn by the Kaplan-Meier method and compared by the Log-rank test. The univariable and multivariable Cox regression analyses calculated the hazard ratio (HR) and 95% confidence interval (CI) for overall mortality. The propensity-score matching analysis was used to reduce the selection bias.
Age, surgery, histological type, N classification, M classification, marital status, and tumor grading were identified as independent prognostic factors after eliminating confounding factors. The results of the Kaplan-Meier method revealed that patients with age < 65 had a survival advantage over those with age ≥ 65 (HR = 1.908, 95% CI 1.549-2.348, P < 0.001). The 5-year OS rates were 28% and 8% in the group with age < 65 and age ≥ 65, respectively (P < 0.001). Cases with surgery had better survival over patients without surgery (HR = 0.372, 95% CI 0.265-0.522, P < 0.001). Compared with patients who did not undergo operations, patients with surgery had a higher median survival time (20 vs. 174 months). For patients with surgery, young age was considered a survival-promoting factor (HR 2.484; 95% CI 1.238-4.983, P = 0.010).
We suggested that age and surgery were the independent prognostic factors in patients with primary malignant trachea tumors. Besides, age serves as an essential indicator for evaluating the prognosis of postoperative patients.
本研究旨在探讨手术和年龄对原发性气管恶性肿瘤患者预后的生存意义。
使用公共数据库中的数据对 637 名原发性气管恶性肿瘤患者进行了主要分析。采用 Kaplan-Meier 法绘制总生存（OS）曲线，并通过对数秩检验进行比较。单变量和多变量 Cox 回归分析计算了全因死亡率的风险比（HR）和 95%置信区间（CI）。采用倾向评分匹配分析来减少选择偏倚。
在消除混杂因素后，年龄、手术、组织学类型、N 分类、M 分类、婚姻状况和肿瘤分级被确定为独立的预后因素。Kaplan-Meier 法的结果表明，年龄<65 岁的患者比年龄≥65 岁的患者具有生存优势（HR=1.908，95%CI 1.549-2.348，P<0.001）。年龄<65 岁和年龄≥65 岁的患者 5 年 OS 率分别为 28%和 8%（P<0.001）。接受手术的患者比未接受手术的患者生存更好（HR=0.372，95%CI 0.265-0.522，P<0.001）。与未接受手术的患者相比，接受手术的患者中位生存时间更长（20 个月 vs. 174 个月）。对于接受手术的患者，年龄较小被认为是一个生存促进因素（HR 2.484；95%CI 1.238-4.983，P=0.010）。
我们认为年龄和手术是原发性气管恶性肿瘤患者的独立预后因素。此外，年龄是评估术后患者预后的重要指标。
