Analysis of survival and prognostic factors of patients with intracranial ependymoma
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摘要:
目的 研究影响颅内室管膜瘤患者生存和预后的相关因素, 为临床治疗提供理论依据。 方法 回顾性分析2008年1月至2018年1月中南大学湘雅医院收治的颅内室管膜瘤患者276例, 分析性别、年龄、肿瘤部位、肿瘤直径、手术切除程度、病理分级、Ki-67指数、术后是否放疗、术后是否化疗对颅内室管膜瘤患者总生存时间和无进展生存时间的影响。 结果 肿瘤部位、手术切除程度、术后是否放疗均能影响颅内室管膜瘤患者总生存时间和无进展生存时间(P<0.001), 并且是影响总生存时间(P<0.001, P<0.001, P = 0.002)和无进展生存时间(P<0.001, P<0.001, P<0.001)的独立因素; Ki-67指数是影响颅内室管膜瘤患者无进展生存的独立因素(P<0.001)。肿瘤位于幕上、Ki-67指数≥10%是提示预后不佳的独立危险因素(P<0.001), 肿瘤全切、术后行放疗是保护因素(P<0.001, P=0.001)。 结论 肿瘤部位、手术切除程度、Ki-67指数、术后是否放疗是响颅内室管膜瘤预后的独立因素, 尽可能的肿瘤全切和术后放疗有助于延长患者的无进展生存时间和总生存时间。 Abstract:Objective To study the factors affecting the survival and prognosis of patients with intracranial ependymoma. Methods From January 2008 to January 2018, the prognoses of 276 patients with intracranial ependymoma were analyzed using Log-rank and Cox model analysis.The variables included sex, age, tumor location, tumor diameter, resection extent, pathological grade, Ki-67 index, postoperative radiotherapy, and postoperative chemotherapy. Results Tumor location, resection extent, and postoperative radiotherapy could all affect the overall survival (OS) and progression-free survival (PFS) of patients with intracranial ependymoma (P<0.001) and independently affected the OS (P<0.001, P<0.001, and P =0.002, respectively) and PFS (P<0.001, P<0.001, and P=0.001, respectively). The Ki-67 index was an independent factor affecting PFS in patients with intracranial ependymoma (P<0.001).The supratentorial location and Ki-67 index ≥10% were independent risk factors indicating poor prognosis (P<0.001).Total resection and postoperative radiotherapy were protective factors (P<0.001 and P =0.001, respectively). Conclusions Tumor location, resection extent, Ki-67 index, and postoperative radiotherapy are independent factors affecting the prognosis of intracranial ependymoma.It is helpful to extend the PFS and OS of patients through complete tumor resection or postoperative radiotherapy. -
Key words:
- ependymoma /
- survival /
- prognosis /
- related factors
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表 1 276例颅内室管膜瘤患者的一般资料
表 2 276例颅内室管膜瘤患者总生存率的单因素分析
表 3 276例颅内室管膜瘤患者无进展生存率的单因素分析
表 4 276例颅内室管膜瘤患者总生存率的多因素分析
表 5 276例颅内室管膜瘤患者无进展生存率的多因素分析
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