Maguire A, Porta M, Sanz-Anquela J M, Ruano I, Malats N, Piñol J L
Institut Municipal d'Investigació Mèdica, Universitat Autònoma de Barcelona, Spain.
Eur J Cancer. 1996 Jul;32A(8):1303-9. doi: 10.1016/0959-8049(96)00103-7.
The aim of this study was to assess whether survival of gastric cancer patients differed between males and females. Although it is well known that the incidence of gastric cancer is higher for men than for women, the existence of a sex-specific prognosis has seldom been addressed. Studies based on population registries have not assessed the role of stage and histology. Cases of histologically confirmed gastric carcinoma were obtained from three Spanish hospitals in Soria (n = 405), Barcelona (n = 249) and Mataró (n = 197). Differences in possible confounders were tested between men and women and survival analyses were performed separately by hospital. Cox's proportional hazards models were used to account for age, tumour stage, histology and tumour sub-location. Only in Mataró was a significant difference in the stage distribution observed between women and men, with a lower proportion of local stage tumours among women (P = 0.047). No statistically significant differences of histological type between men and women were observed in any of the centres. After adjusting for tumour stage and age, women were observed to have significantly better survival in Barcelona (female to male hazard ratio (HR) = 0.578, P < 0.001); this effect was marginal in Soria (HR = 0.788, P = 0.092) and non-significant in Matar-o (HR = 0.895, P = 0.54). Age-adjusted hazard ratios were calculated within each tumour stage. For Barcelona, the effect of better prognosis among women was most marked at local stage (HR = 0.320, P = 0.013), and in Soria at the regional stage (HR = 0.426, P = 0.002). Although in Mataró all HRs were below unity, none were statistically significant. Little effect was observed at the disseminated stage. The other covariables exerted no influence. Women appear to have a better prognosis than men, and the difference could be tumour stage dependent. Confirmation of these findings would give a valuable insight into gastric cancer growth and ultimately be of use in planning treatment.
本研究的目的是评估胃癌患者的生存率在男性和女性之间是否存在差异。尽管众所周知，男性胃癌的发病率高于女性，但性别特异性预后的存在很少被提及。基于人口登记的研究尚未评估分期和组织学的作用。组织学确诊的胃癌病例来自索里亚的三家西班牙医院（n = 405）、巴塞罗那（n = 249）和马塔罗（n = 197）。对男性和女性之间可能的混杂因素差异进行了检验，并按医院分别进行生存分析。采用Cox比例风险模型来考虑年龄、肿瘤分期、组织学和肿瘤亚部位。仅在马塔罗观察到女性和男性之间的分期分布存在显著差异，女性局部阶段肿瘤的比例较低（P = 0.047）。在任何一个中心，均未观察到男性和女性之间组织学类型存在统计学显著差异。在调整肿瘤分期和年龄后，观察到巴塞罗那的女性生存率显著更好（女性与男性风险比（HR）= 0.578，P < 0.001）；在索里亚这种影响不明显（HR = 0.788，P = 0.092），在马塔罗则无显著差异（HR = 0.895，P = 0.54）。在每个肿瘤分期内计算年龄调整后的风险比。对于巴塞罗那，女性预后较好的影响在局部阶段最为明显（HR = 0.320，P = 0.013），在索里亚则在区域阶段（HR = 0.426，P = 0.002）。尽管在马塔罗所有HR均低于1，但均无统计学显著性。在播散阶段观察到的影响很小。其他协变量没有影响。女性似乎比男性预后更好，且这种差异可能取决于肿瘤分期。这些发现的证实将为胃癌生长提供有价值的见解，并最终有助于规划治疗。
