杨欢, 王晓坤, 石素胜, 蒋力明, 依荷芭丽·迟, 范金虎, 乔友林. 不同年龄胃肠胰神经内分泌肿瘤患者预后分析[J]. 中国肿瘤临床, 2022, 49(15): 792-796. DOI: 10.12354/j.issn.1000-8179.2022.20220089
引用本文: 杨欢, 王晓坤, 石素胜, 蒋力明, 依荷芭丽·迟, 范金虎, 乔友林. 不同年龄胃肠胰神经内分泌肿瘤患者预后分析[J]. 中国肿瘤临床, 2022, 49(15): 792-796. DOI: 10.12354/j.issn.1000-8179.2022.20220089
Huan Yang, Xiaokun Wang, Susheng Shi, Liming Jiang, Yihebali·Chi, Jinhu Fan, Youlin Qiao. Prognostic analysis of patients with gastroenteropancreatic neuroendocrine neoplasms at different ages[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(15): 792-796. DOI: 10.12354/j.issn.1000-8179.2022.20220089
Citation: Huan Yang, Xiaokun Wang, Susheng Shi, Liming Jiang, Yihebali·Chi, Jinhu Fan, Youlin Qiao. Prognostic analysis of patients with gastroenteropancreatic neuroendocrine neoplasms at different ages[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 49(15): 792-796. DOI: 10.12354/j.issn.1000-8179.2022.20220089

不同年龄胃肠胰神经内分泌肿瘤患者预后分析

Prognostic analysis of patients with gastroenteropancreatic neuroendocrine neoplasms at different ages

  • 摘要:
      目的  本研究旨在描述中国不同诊断年龄胃肠胰神经内分泌肿瘤(gastroenteropancreatic neuroendocrine neoplasms,GEP-NENs)患者的临床病理特征和治疗信息,探讨诊断年龄与术后5年生存率之间的关系。
      方法  作为一项以医院为基础的全国多中心临床流行病学研究,本研究回顾性收集了2001年1月至2010年12月在研究医院就诊的GEP-NENs患者的病历信息和术后生存情况。采用Cox风险比例回归模型估计研究对象的术后死亡风险比和95%可信区间(95%CI)。
      结果  共2 002例患者被纳入最终分析。患者按照诊断年龄分为≤50岁组和>50岁组。术后5年生存数据分析显示,与年龄≤50岁的患者相比,年龄>50岁的患者术后死亡风险显著增加(HR=2.83,95%CI:1.87~4.28)。在调整了原发部位、功能状态、TNM分期、分级、肿瘤浸润和转移情况、放化疗、靶向治疗和生物治疗情况后,不同年龄组之间的死亡风险差异无统计学意义(HR=1.63,95%CI:0.98~2.72)。对性别亚组进行多因素分析结果显示,在男性患者中,年龄>50岁组患者术后死亡风险显著增加(HR=2.65,95%CI:1.28~5.47)。
      结论  不同年龄组GEP-NENs患者的临床病理特征和治疗方式选择存在差异,但年龄不是GEP-NENs患者预后的独立影响因素,提示对于诊断年龄不同的患者,临床医生应根据现有临床实践指南及患者个体情况,选择精准治疗方案。

     

    Abstract: Objective : To assess clinicopathological features and treatment options of patients with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) at different ages and explore associations between age and five-year survival rate after surgery. Methods: In this hospital-based, nationwide, multicenter clinical epidemiological study, we retrospectively collected medical and survival data after surgery from 2, 010 patients with GEP-NENs enrolled in the study hospitals from January 2001 to December 2010. The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) to determine the risk for death after surgery. Results: The patients were assigned into two groups based on their age at diagnosis: ≤50 years and >50 years. Analysis of the five-year survival data after surgery revealed that the risk for death was significantly higher in patients aged >50 years than in those aged ≤50 years (HR=2.83, 95% CI: 1.87-4.28). After adjusting for primary sites, TNM stage, tumor grade, depth of invasion, lymph node metastasis and distant metastasis status, chemoradiotherapy, target therapy, and biotherapy, all HRs were not statistically significant (All P>0.05). Subgroup multivariate analysis according to sex showed that patients aged >50 years had significantly increased risks for death among male patients. Conclusions: Differences were noted in clinicopathological characteristics and treatment options of patients with GEP-NENs in different age groups. The five-year survival rate of patients with GEP-NENs aged >50 years is low, but age at diagnosis is not an independent factor affecting prognosis, indicating that according to the current clinical practice guidelines for GEP-NENs, precise and personalized treatment should be selected for patients with different ages at diagnosis.

     

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