上腺皮质癌患者的预后因素和治疗结果:基于注册表的研究
Tao Chen1, Dongyang Zeng, Guang Zhou
1Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Medicine
|July 29, 2025
概括
上皮层癌 (ACC) 的预后不好. 关键的生存因素包括年龄,阶段和年级. 手术和放射治疗显著改善了ACC患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 临床研究 临床研究
背景情况:
- 上皮层癌 (ACC) 是一种罕见的内分泌恶性瘤,对其预后和治疗影响的了解有限.
- 对ACC的预后因素和治疗策略的系统调查对于改善患者的治疗结果至关重要.
研究的目的:
- 在ACC患者中确定影响整体生存 (OS) 和癌症特异性生存 (CSS) 的预后因素.
- 评估包括手术和放射治疗在内的治疗方式对ACC中的OS和CSS的影响.
主要方法:
- 利用了监测,流行病学和最终结果 (SEER) 注册表数据,用于2000年至2021年间诊断的ACC病例.
- 采用Kaplan-Meier分析进行生存评估和考克斯回归模型,包括定向环形图 (DAG),以确定风险预测因素和治疗效应.
主要成果:
- 这项研究包括444名ACC患者,中位数OS为25个月,CSS为30个月.
- 与更糟糕的存活率相关的因素包括年龄 (≥53岁),先进的病理级 (III/IV),更高的临床阶段 (III/IV),先进的瘤 (T3/4),阳性淋巴结 (N1),远程转移 (M1),以及缺乏手术或放射治疗.
- 发现手术切除和放射治疗都能显著改善OS和CSS.
结论:
- 上腺皮质癌表现出侵略性行为和普遍不良的预后.
- 在ACC中生存率差的预测因素包括晚年,病理级别差,临床晚期和晚期瘤结节转移 (TNM) 分类.
- 手术切除是ACC的有效治疗方法,放射治疗提供了缓和和有益的效果,特别是在晚期.
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