目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库...目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库中筛选2000年1月—2020年12月诊断为OYST的患者共358例,将其按3:1的比例随机分为训练集(266例)和验证集(92例)。采用单因素和多因素竞争风险分析肿瘤特异性生存期的独立影响因素,构建1年、3年、5年肿瘤特异性生存率的列线图预测模型,并通过一致性指数(C指数)、受试者工作特征曲线下面积(area under the curve,AUC)、校准曲线、Hosmer-Lemeshow拟合优度检验、决策曲线分析评估模型的区分度、准确性及实用性。通过建立风险分层系统,将患者分成高、低风险人群,采用Kaplan-Meier曲线分析2组人群的生存差异。结果:多因素竞争风险分析结果显示,年龄、手术和区域淋巴结清扫是OYST患者肿瘤特异性生存期的独立影响因素。据此构建列线图预测模型,训练集和验证集的C指数分别为0.829(95%CI:0.825~0.833)和0.808(95%CI:0.804~0.812),预测1年、3年、5年肿瘤特异性生存率的AUC分别为0.927、0.833、0.815和0.982、0.880、0.745。校准曲线及HosmerLemeshow拟合优度检验显示模型预测的OYST患者肿瘤特异性生存率与实际生存率具有较好的一致性。临床决策分析曲线表明该模型有一定的临床实用性。Kaplan-Meier曲线显示高风险人群的肿瘤特异性生存率显著低于低风险人群(均P<0.0001)。结论:构建的OYST患者肿瘤特异性生存率的列线图预测模型具有良好的区分度和准确度,可帮助临床医师评估患者预后,制定个体化治疗方案改善患者预后。展开更多
Background: Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor of vascular origin with an unknown etiology, a low incidence, and a variable natural course. We evaluated the management and prognosis of HEH ...Background: Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor of vascular origin with an unknown etiology, a low incidence, and a variable natural course. We evaluated the management and prognosis of HEH from the Surveillance, Epidemiology and End Results (SEER) program and changes in treatment modalities of HEH over 30 years. Methods: From 1973 to 2014 in the SEER database, we selected patients diagnosed with HEH. We analyzed the clinical characteristics, patterns of management, and clinical outcomes of patients with HEH. Results: We identi ed 79 patients with HEH (median age: 54.0 years;male to female ratio: 1:2.6). The initial extent of disease was local in 22 (27.8%) patients, regional metastasis in 22 (27.8%), distant metas-tasis in 31 (39.2%) and unknown in 4 (5.1%). The median size of primary tumor was 3.85 cm (interquartile range, 2.50 7.93 cm). Among 74 patients with available management data, the most common manage-ment was no treatment (29/74, 39.2%), followed by chemotherapy only (22/74, 29.7%), liver resection-based (13/74, 17.6%), and transplantation-based therapy (6/74, 8.1%). The 5-year cancer-speci c survival rate was 57.8%. Patients who underwent surgical treatment had signi cantly higher survival than those who underwent non-surgical treatment (5-year survival;88% vs. 49%, P=0.019). Multivariate analysis revealed that surgical therapy was the only independent prognostic factor for survival (hazard ratio: 0.20, P=0.040). Conclusions: Resection or liver transplantation is worth considering for treatment of patients with HEH.展开更多
目的探讨婚姻状态与结直肠神经内分泌肿瘤患者远期预后的关系。方法利用美国SEER数据库中1988至2011年间诊断为结直肠神经内分泌肿瘤(不包括阑尾)的病例回顾性分析婚姻状态与总因死亡(overall-cause mortality,OM)和肿瘤特异性死亡(canc...目的探讨婚姻状态与结直肠神经内分泌肿瘤患者远期预后的关系。方法利用美国SEER数据库中1988至2011年间诊断为结直肠神经内分泌肿瘤(不包括阑尾)的病例回顾性分析婚姻状态与总因死亡(overall-cause mortality,OM)和肿瘤特异性死亡(cancer-specific mortality,CSM)的关系;应用单因素和多因素Cox分析婚姻状态(已婚,未婚和离异、分居、丧偶)对结直肠内分泌肿瘤远期预后的影响。结果共入组2 962例患者中,已婚组占60%,未婚组占14%,分居、离婚、丧偶(S D W)组占26%。多因素C ox回归分析表明,相比于已婚组及未婚组,SDW组的肿瘤特异性死亡(HR=1.15,P=0.038)和总因死亡(HR=1.19,P=0.002)均较高;相比于已婚组,未婚组总因死亡(HR=1.24,P=0.006)较高。结论 S D W患者有较高的CSM和OM;该风险独立于年龄、ENETS分期、肿瘤位置、就诊年份。提醒医务人员在这类患者诊治过程中应提供更多关注。展开更多
文摘目的:分析卵巢卵黄囊瘤(ovarian yolk sac tumor,OYST)患者肿瘤特异性生存期的相关影响因素,构建OYST患者肿瘤特异性生存率的列线图预测模型。方法:从监测、流行病学和结局(The Surveillance,Epidemiology,and End Results,SEER)数据库中筛选2000年1月—2020年12月诊断为OYST的患者共358例,将其按3:1的比例随机分为训练集(266例)和验证集(92例)。采用单因素和多因素竞争风险分析肿瘤特异性生存期的独立影响因素,构建1年、3年、5年肿瘤特异性生存率的列线图预测模型,并通过一致性指数(C指数)、受试者工作特征曲线下面积(area under the curve,AUC)、校准曲线、Hosmer-Lemeshow拟合优度检验、决策曲线分析评估模型的区分度、准确性及实用性。通过建立风险分层系统,将患者分成高、低风险人群,采用Kaplan-Meier曲线分析2组人群的生存差异。结果:多因素竞争风险分析结果显示,年龄、手术和区域淋巴结清扫是OYST患者肿瘤特异性生存期的独立影响因素。据此构建列线图预测模型,训练集和验证集的C指数分别为0.829(95%CI:0.825~0.833)和0.808(95%CI:0.804~0.812),预测1年、3年、5年肿瘤特异性生存率的AUC分别为0.927、0.833、0.815和0.982、0.880、0.745。校准曲线及HosmerLemeshow拟合优度检验显示模型预测的OYST患者肿瘤特异性生存率与实际生存率具有较好的一致性。临床决策分析曲线表明该模型有一定的临床实用性。Kaplan-Meier曲线显示高风险人群的肿瘤特异性生存率显著低于低风险人群(均P<0.0001)。结论:构建的OYST患者肿瘤特异性生存率的列线图预测模型具有良好的区分度和准确度,可帮助临床医师评估患者预后,制定个体化治疗方案改善患者预后。
基金supported by the Bio&Medical Tech-nology Development Program of the National Research Foun-dation(NRF)funded by the Korean government(MSIT)(NRF-2018M3A9E8023861)by a grant from the Korean Health R&D Project.Ministry of Health Welfare,Korea(HI18C0531)
文摘Background: Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor of vascular origin with an unknown etiology, a low incidence, and a variable natural course. We evaluated the management and prognosis of HEH from the Surveillance, Epidemiology and End Results (SEER) program and changes in treatment modalities of HEH over 30 years. Methods: From 1973 to 2014 in the SEER database, we selected patients diagnosed with HEH. We analyzed the clinical characteristics, patterns of management, and clinical outcomes of patients with HEH. Results: We identi ed 79 patients with HEH (median age: 54.0 years;male to female ratio: 1:2.6). The initial extent of disease was local in 22 (27.8%) patients, regional metastasis in 22 (27.8%), distant metas-tasis in 31 (39.2%) and unknown in 4 (5.1%). The median size of primary tumor was 3.85 cm (interquartile range, 2.50 7.93 cm). Among 74 patients with available management data, the most common manage-ment was no treatment (29/74, 39.2%), followed by chemotherapy only (22/74, 29.7%), liver resection-based (13/74, 17.6%), and transplantation-based therapy (6/74, 8.1%). The 5-year cancer-speci c survival rate was 57.8%. Patients who underwent surgical treatment had signi cantly higher survival than those who underwent non-surgical treatment (5-year survival;88% vs. 49%, P=0.019). Multivariate analysis revealed that surgical therapy was the only independent prognostic factor for survival (hazard ratio: 0.20, P=0.040). Conclusions: Resection or liver transplantation is worth considering for treatment of patients with HEH.
文摘目的探讨婚姻状态与结直肠神经内分泌肿瘤患者远期预后的关系。方法利用美国SEER数据库中1988至2011年间诊断为结直肠神经内分泌肿瘤(不包括阑尾)的病例回顾性分析婚姻状态与总因死亡(overall-cause mortality,OM)和肿瘤特异性死亡(cancer-specific mortality,CSM)的关系;应用单因素和多因素Cox分析婚姻状态(已婚,未婚和离异、分居、丧偶)对结直肠内分泌肿瘤远期预后的影响。结果共入组2 962例患者中,已婚组占60%,未婚组占14%,分居、离婚、丧偶(S D W)组占26%。多因素C ox回归分析表明,相比于已婚组及未婚组,SDW组的肿瘤特异性死亡(HR=1.15,P=0.038)和总因死亡(HR=1.19,P=0.002)均较高;相比于已婚组,未婚组总因死亡(HR=1.24,P=0.006)较高。结论 S D W患者有较高的CSM和OM;该风险独立于年龄、ENETS分期、肿瘤位置、就诊年份。提醒医务人员在这类患者诊治过程中应提供更多关注。
