对40年SEER数据的治疗和生存分析,用于上食道癌症的上食道癌症
Xi Wu1, Ming-Chuang Zhu2, Guo-Liang Li3
1Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Frontiers in medicine
|August 2, 2023
概括
40年来,食道上部癌症 (UEC) 的生存率有所改善,手术显示出局部疾病的更好的结果. 结合手术和放射治疗有利于区域UEC,特别是状细胞癌.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 医学统计 医学统计
背景情况:
- 上部食道癌 (UEC) 是一种罕见的恶性瘤,对其流行病学和存活率的了解有限.
- 对于UEC的最佳治疗策略仍然是辩论的主题.
- 这项研究调查了UEC患者的趋势和治疗结果.
研究的目的:
- 分析上食道癌 (UEC) 的流行病学特征和长期生存趋势.
- 评估不同治疗方式对UEC患者生存结果的影响.
- 根据疾病阶段和组织学来确定最佳的治疗策略.
主要方法:
- 利用SEER数据库识别1973年至2013年间诊断的UEC病例.
- 雇佣学生的t测试和皮尔森的千平方测试用于比较分析.
- 使用Kaplan-Meier方法和Cox比例危险回归来评估生存率和预测因素.
主要成果:
- 在过去的40年里,UEC的发病率和腺癌的比例有所增加.
- 从1973-1982年到2004-2013年,中位数的整体存活率 (OS) 和食道癌特异性存活率 (ECSS) 显著改善.
- 没有辐射的手术 (SWR) 和辐射加手术 (R+S) 证明了与没有手术的辐射 (RWS) 相比,更高的生存率.
- 对于本地化UEC,SWR产生了最好的结果;对于区域UEC,R+S是优越的.
- 放射疗法测序影响了区域阶段状细胞癌 (SCC) 的OS.
结论:
- 虽然UEC的长期存活率仍然很低,但已经有所改善,这可能是由于医疗保健的进步.
- 治疗方式显著影响UEC的预后,在局部疾病中,手术是可取的.
- 对于区域性UEC,特别是SCC,联合手术和放射治疗 (新辅助或辅助) 可能会改善长期结果.
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