Kang Luyao, Ji Gaili, Liu Duan, Wang Yaping, Meng Jie, Li Hongyu
Department of Gynecologic Oncology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
The Zhengzhou Key Laboratory of Gynecological Oncology, Zhengzhou, 450052, Henan, China.
Discov Oncol. 2024 Oct 2;15(1):518. doi: 10.1007/s12672-024-01403-4.
This study aimed to explore the prognostic factors and survival patterns based on the histological type for the perimenopausal endometrial carcinoma (PIPEC) patients treated with hysterectomy.
The PIPEC patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database. Methods of random survival forest (RSF) and Cox regression were used to identify the possible prognostic factors of PIPEC patients. Then overall survival (OS) and cancer-specific survival (CSS) of PIPEC data were analyzed by histological types with regional lymph nodes status and SEER-stage to investigate the survival patterns of the PIPEC patients.
A total of 14,178 PIPEC patients were included in the study. We found tumor size, grade, histology, SEER-stage, AJCC-stage, AJCC-T stage, metastasis to distant organs and regional lymph nodes status had a significant survival outcome for PIPEC both for OS and CSS (all p < 0.05). Regardless of regional lymph nodes status and SEER-stage for OS and CSS, the low-grade endometrioid carcinoma had the best prognosis outcome, followed by the mix cell adenocarcinoma and high-grade endometrioid carcinoma, while the carcinosarcoma and undifferentiated carcinoma had relatively poor prognosis outcome. And the survival patterns of different histological types of PIPEC were diverse and changed along with the time.
We identified the possible prognostic factors of PIPEC patients treated with hysterectomy. And survival analysis based on the regional lymph nodes status and SEER-stage revealed the different histological types of PIPEC had diverse survival patterns, which will be helpful for guiding clinical practice.
本研究旨在探讨接受子宫切除术治疗的围绝经期子宫内膜癌(PIPEC)患者基于组织学类型的预后因素和生存模式。
从监测、流行病学和最终结果(SEER)数据库中选取PIPEC患者。采用随机生存森林(RSF)和Cox回归方法确定PIPEC患者可能的预后因素。然后根据组织学类型、区域淋巴结状态和SEER分期分析PIPEC数据的总生存期(OS)和癌症特异性生存期(CSS),以研究PIPEC患者的生存模式。
本研究共纳入14178例PIPEC患者。我们发现肿瘤大小、分级、组织学、SEER分期、AJCC分期、AJCC-T分期、远处器官转移和区域淋巴结状态对PIPEC的OS和CSS均有显著的生存结局(所有p<0.05)。无论OS和CSS的区域淋巴结状态和SEER分期如何,低级别子宫内膜样癌的预后最佳,其次是混合细胞腺癌和高级别子宫内膜样癌,而癌肉瘤和未分化癌的预后相对较差。不同组织学类型的PIPEC的生存模式各不相同,且随时间变化。
我们确定了接受子宫切除术治疗的PIPEC患者可能的预后因素。基于区域淋巴结状态和SEER分期的生存分析显示,不同组织学类型的PIPEC具有不同的生存模式,这将有助于指导临床实践。