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基于人群的儿童和青少年性腺和性腺外卵黄囊瘤的临床特征和预后模型分析。

Clinical characteristics and prognostic models of gonadal and extra-gonadal yolk sac tumors: a population-based analysis in children and adolescents.

机构信息

Department of General Surgery, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu, China.

Department of Pediatric Surgery, Hangzhou Children's Hospital, Hangzhou, 310015, Zhejiang, China.

出版信息

World J Urol. 2023 Nov;41(11):3009-3017. doi: 10.1007/s00345-023-04616-4. Epub 2023 Sep 25.

Abstract

PURPOSE

Yolk sac tumors (YST) are a rare and aggressive germ cell tumor. We aimed to conduct a population-based cohort study and develop a nomogram to predict overall survival (OS) in pediatric patients with YST.

METHODS

The Surveillance, Epidemiology, and End Results (SEER) database was used to identify all pediatric patients with YST diagnosed between 2000 and 2018. The log-rank test was used to compare survival curves. To examine the impact of each factor on overall survival, a multivariate Cox proportional hazards model was created. Based on the results of the Cox regression model, a nomogram was constructed.

RESULTS

A total of 520 YST patients were identified. Overall survival rates for all patients were 92.2% at 3-year and 90.3% at 5-year, respectively. The outcome of Cox proportional hazard regression revealed that age, gender, primary sites, and treatment regimens were important independent predictors in this model. Based on the Cox regression model, we created a nomogram for predicting OS in pediatric YST patients. The chance of death increased with age in patients. Furthermore, patients with extra-gonadal YST have a lower survival rate than those with gonadal YST.

CONCLUSIONS

Our study revealed that age, gender, and primary site were found to be the most important predictors of the overall survival of pediatric YST, providing crucial epidemiological information for clinical management.

摘要

目的

卵黄囊瘤(YST)是一种罕见且侵袭性的生殖细胞肿瘤。本研究旨在进行基于人群的队列研究,并构建列线图预测儿科 YST 患者的总生存率(OS)。

方法

利用监测、流行病学和最终结果(SEER)数据库,确定 2000 年至 2018 年间诊断为 YST 的所有儿科患者。采用对数秩检验比较生存曲线。采用多变量 Cox 比例风险模型来评估每个因素对总生存的影响。基于 Cox 回归模型的结果,构建了一个列线图。

结果

共纳入 520 例 YST 患者。所有患者的 3 年和 5 年总生存率分别为 92.2%和 90.3%。Cox 比例风险回归的结果表明,年龄、性别、原发部位和治疗方案是该模型中的重要独立预测因素。基于 Cox 回归模型,我们为儿科 YST 患者的 OS 预测创建了一个列线图。患者的死亡风险随年龄的增加而增加。此外,与性腺 YST 患者相比,发生在性腺外的 YST 患者的生存率较低。

结论

本研究表明,年龄、性别和原发部位是儿科 YST 总生存率的最重要预测因素,为临床管理提供了重要的流行病学信息。

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