65岁及以上宫癌患者的治疗模式和预后:基于人口的队列研究
Linying Liu1, Suhong Zhuang1,2, Jianfeng Zheng1
1Department of Gynecology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian, People's Republic of China.
Annals of surgical oncology
|November 24, 2025
概括
老年宫癌患者的疾病往往已晚期,并且接受的治疗较少. 手术改善了生存率,但考虑到风险和非癌症死亡,个性化护理至关重要.
科学领域:
- 在瘤学瘤学.
- 老年医学 老年医学
- 癌症流行病学 癌症流行病学
背景情况:
- 子宫癌 (CC) 不成比例地影响着老年人,但在这个人口群体中,治疗模式和结果尚未确定.
- 了解老年CC患者面临的具体挑战对于改善他们的护理和生存率至关重要.
研究的目的:
- 研究被诊断患有宫癌的老年患者 (≥65岁) 的治疗策略和预后.
- 为了比较老年人和年轻的宫癌患者队列之间的结果.
主要方法:
- 对监测,流行病学和最终结果 (SEER) 数据库 (2000-2019) 的回顾性分析.
- 倾向性得分匹配 (PSM) 用于平衡患者组之间的基线特征.
- 使用卡普兰-梅尔分析和Cox比例危险模型来评估整体存活率 (OS).
主要成果:
- 较年长的CC患者 (15.3%) 呈现出更晚期的疾病,并且与年轻的队列相比,接受了更少的激进手术.
- 在PSM后的分析显示,老年患者的生存率明显低于年轻和中年人群 (HR=1.91和HR=1.63,分别;p<0.0001).
- 手术,特别是早期疾病的激进手术,改善了OS. 对于无法切除的局部晚期CC,结合的激进手术和放射治疗产生了最好的5年生存率 (61.2%). 非癌症死亡率随着年龄的增长而增加,特别是手术后.
结论:
- 老年宫癌患者面临的挑战包括在诊断时的晚期疾病和减少治疗强度.
- 手术对老年患者有好处,但治疗决策必须是个性化的.
- 优化结果需要仔细考虑手术资格,术后风险和与年龄相关的非癌症死亡率.
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