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与儿科和青少年肾细胞癌患者生存相关的因素:一项基于人群的研究。

Factors associated with survival in paediatric and adolescent renal cell carcinoma: a population-based study.

机构信息

Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

Department of Pediatrics, The Second Hospital of Anhui Medical University, Hefei, China.

出版信息

ANZ J Surg. 2023 Nov;93(11):2710-2715. doi: 10.1111/ans.18614. Epub 2023 Jul 17.

Abstract

BACKGROUND

The purpose of this study was to conduct a population-based study to determine the prognosis of renal cell carcinoma (RCC) in children and adolescents.

METHODS

Patients with RCC who were registered in the Surveillance, Epidemiology, and End Results (SEER) program between 2000 and 2018 had their demographic and clinical characteristics evaluated retrospectively. The log-rank test was used to compare survival curves. Kaplan-Meier estimates were used to generate survival curves based on various factors. To identify factors associated with overall survival, Cox proportional-hazards regression was used.

RESULTS

A total of 251 patients were enrolled in the study. For all patients, the overall survival (OS) rates at 3- and 5- year were 93.5% and 92.0%, respectively. A multivariable study revealed that the following factors were independently associated with overall survival: sex, race, histologic type, SEER stage, AJCC stage, and type of surgery. Cox analysis showed that white patients had the lowest risk of mortality (hazard ratio (HR) 2.58, 95% confidence interval (CI), 1.33-4.99; P = 0.005), compared with black patients. Patients having metastatic disease had significantly higher mortality risk (HR 43, 95% CI, 14.8-125; P < 0.001) than the patients with localized tumour.

CONCLUSIONS

Our study emphasizes the importance of race, SEER stage, and surgery in the prognosis of paediatric RCC, providing valuable epidemiological evidence for clinical practice. Economic studies assessing a race/ethnic group specific strategy are also required.

摘要

背景

本研究旨在进行一项基于人群的研究,以确定儿童和青少年肾细胞癌(RCC)的预后。

方法

回顾性评估了 2000 年至 2018 年间在监测、流行病学和最终结果(SEER)计划中登记的 RCC 患者的人口统计学和临床特征。使用对数秩检验比较生存曲线。Kaplan-Meier 估计用于根据各种因素生成生存曲线。使用 Cox 比例风险回归确定与总生存相关的因素。

结果

共有 251 名患者入组研究。所有患者的 3 年和 5 年总生存率(OS)分别为 93.5%和 92.0%。多变量研究表明,以下因素与总生存独立相关:性别、种族、组织学类型、SEER 分期、AJCC 分期和手术类型。Cox 分析显示,与黑人患者相比,白人患者的死亡风险最低(危险比(HR)2.58,95%置信区间(CI)1.33-4.99;P=0.005)。患有转移性疾病的患者的死亡风险明显更高(HR 43,95%CI,14.8-125;P<0.001),而局限性肿瘤患者的死亡风险较低。

结论

我们的研究强调了种族、SEER 分期和手术在儿科 RCC 预后中的重要性,为临床实践提供了有价值的流行病学证据。还需要进行评估种族/民族特定策略的经济研究。

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