Department of Urology, Hainan Women and Children's Medical Center, Haikou, Hainan, China.
Department of Urology, Children's Hospital of Fudan University, Shanghai, China.
PLoS One. 2024 Sep 19;19(9):e0308824. doi: 10.1371/journal.pone.0308824. eCollection 2024.
To explore the association between radiation after surgery and the 5-year overall survival (OS) and 5-year cancer-specific survival (CSS) in patients with Wilms tumor.
In this cohort study, 1564 participants were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The univariate and multivariable COX proportional risk model as well as competitive risk model were used to explore the covariates associated with 5-year OS and 5-year CSS of patients with Wilms tumor and the correlation between radiation after surgery and 5-year OS or 5-year CSS of patients with Wilms tumor, respectively. The Kaplan-Meier curves of participants were plotted.
The median follow-up was 126.00 (84.00, 178.00) months. Patients receiving surgery had higher 5-year survival probability than those not receiving surgery, while participants receiving radiation after surgery showed poor 5-year survival than those not. After adjusting for covariates including age and SEER stage, increased risk of 5-year overall mortality in patients with Wilms tumor [hazard ratio (HR) = 1.62, 95% confidence interval (CI): 1.10-2.41). After the adjustment for confounding factors including age, SEER stage and ethnicity, increased risk of 5-year cancer-specific mortality of patients with Wilms tumor was observed in those receiving radiation after surgery (HR = 1.77, 95%CI: 1.13-2.79).
Radiation after surgery was associated with poor prognosis of patients with Wilms tumor, which indicated that the clinicians should assess whether the patient was suitable for using radiation after surgery.
探讨术后放疗与 Wilms 瘤患者 5 年总生存率（OS）和 5 年癌症特异性生存率（CSS）的关系。
在这项队列研究中，我们从监测、流行病学和最终结果（SEER）数据库中确定了 1564 名参与者。采用单变量和多变量 COX 比例风险模型以及竞争风险模型，探讨与 Wilms 瘤患者 5 年 OS 和 5 年 CSS 相关的协变量，以及术后放疗与 Wilms 瘤患者 5 年 OS 或 5 年 CSS 的相关性。绘制了参与者的 Kaplan-Meier 曲线。
中位随访时间为 126.00（84.00，178.00）个月。接受手术的患者比未接受手术的患者具有更高的 5 年生存率，但接受术后放疗的患者 5 年生存率较差。在调整了包括年龄和 SEER 分期在内的协变量后，Wilms 瘤患者的 5 年总死亡率风险增加[风险比（HR）=1.62，95%置信区间（CI）：1.10-2.41]。在调整了包括年龄、SEER 分期和种族在内的混杂因素后，接受术后放疗的 Wilms 瘤患者的 5 年癌症特异性死亡率风险增加（HR=1.77，95%CI：1.13-2.79）。
术后放疗与 Wilms 瘤患者的不良预后相关，这表明临床医生应评估患者是否适合接受术后放疗。
