Chen Xiaoxiao, Chen Yizhou, Xiao Fangping, Liu Meng, Gu Zhan, Li Yi, Hong Mei
The Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan, Nanjing, China.
J Cancer Res Clin Oncol. 2023 Nov;149(17):15687-15696. doi: 10.1007/s00432-023-05351-4. Epub 2023 Sep 4.
The purpose of this study was to use the Surveillance, Epidemiology, and End Results (SEER) database to evaluate the survival rate of primary malignant cardiac tumors (PMCTs), assess the risk factors affecting survival, and calculate the number of PMCT cases in recent years.
SEER 22 registries were used to calculate the number of cases PMCT. Data on age, sex, race, marital status, tumor size, the American Joint Committee on Cancer (AJCC) stage, lymph node involvement, metastasis, treatment, and survival were collected to analyze the survival and prognostic factors of SEER 17 registries. Using the Kaplan-Meier estimation method, a survival curve was obtained according to the influencing factors, and a multivariable Cox regression model was established.
In recent years, the average annual number of PMCT cases was 20.56 ± 7.12, significantly higher than the average before 2004 (P = 0.015; 95% CI 1.14-8.98). The 1-, 3-, and 5-year survival rates were 45.6%, 18.8%, and 11.2%, respectively. Multivariate analysis revealed that age (risk ratio [HR], 2.047; 95% CI 1.381-3.034), AJCC stage III (HR, 1.786; 95% CI 1.123-2.839), AJCC staging with distant metastasis (HR, 2.666; 95% CI 1.509-4.709), no chemotherapy (HR, 2.011; 95% CI 1.561-2.590), and tumor size larger than 99 mm (HR, 1.766; 95% CI 1.132-2.756) were independent risk factors for poor prognosis. Only age over 76 years and distant metastasis were independent risk factors for prognosis in the chemotherapy group.
In recent years, the annual number of patients with PMCT has increased significantly. Due to developments in chemotherapy, we should re-evaluate the traditional tumor staging and prognostic risk indicators to improve clinical applications.
本研究旨在利用监测、流行病学和最终结果（SEER）数据库评估原发性恶性心脏肿瘤（PMCT）的生存率，评估影响生存的危险因素，并计算近年来PMCT的病例数。
使用SEER 22个登记处的数据计算PMCT病例数。收集年龄、性别、种族、婚姻状况、肿瘤大小、美国癌症联合委员会（AJCC）分期、淋巴结受累情况、转移情况、治疗情况和生存情况等数据，以分析SEER 17个登记处的生存情况和预后因素。采用Kaplan-Meier估计方法，根据影响因素获得生存曲线，并建立多变量Cox回归模型。
近年来，PMCT病例的年平均数量为20.56±7.12，显著高于2004年以前的平均水平（P = 0.015；95%CI 1.14 - 8.98）。1年、3年和5年生存率分别为45.6%、18.8%和11.2%。多变量分析显示，年龄（风险比[HR]，2.047；95%CI 1.381 - 3.034）、AJCC III期（HR，1.786；95%CI 1.123 - 2.839）、伴有远处转移的AJCC分期（HR，2.666；95%CI 1.509 - 4.709）、未进行化疗（HR，2.011；95%CI 1.561 - 2.590）以及肿瘤大小大于99 mm（HR，1.766；95%CI 1.132 - 2.756）是预后不良的独立危险因素。在化疗组中，只有年龄超过76岁和远处转移是预后的独立危险因素。
近年来，PMCT患者的年数量显著增加。由于化疗的发展，我们应该重新评估传统的肿瘤分期和预后风险指标，以改善临床应用。
