2008—2017年江苏省南通市肿瘤医院皮肤癌住院患者生存率分析

Survival Analysis of Hospitalized Patients with Skin Cancer in Nantong Tumor Hospital from 2008 to 2017

[目的]对2008—2017年在南通市肿瘤医院住院的皮肤癌患者进行生存分析。[方法]采用被动随访与主动随访相结合的方法,对皮肤癌住院患者进行生存结局随访,随访截止时间为2020年12月31日。采用Kaplan-Meier法计算观察生存率(OSR),差异比较使用Logrank检验,并采用Cox回归进行多因素分析。通过R软件构建列线图生存率预测模型,计算Cox模型的一致性指数(C-index)并绘制校准曲线验证模型的有效性。[结果]共纳入328例皮肤癌患者,其中男性168例,女性160例。5年OSR为66.31%。单因素分析显示,TNM分期、治疗方式和肿瘤类型为皮肤癌患者生存率的影响因素(P<0.05)。多因素分析显示,采取其他治疗手段是影响皮肤癌生存率的独立危险因素(P<0.05)。模型的C-index值为0.618,校准曲线显示皮肤癌患者的生存率的预测校准曲线与理想参考线拟合度良好,提示该模型预测准确度较好。[结论]南通市肿瘤医院皮肤癌住院患者的5年生存率相对较高,但分型为恶性黑色素瘤的患者预后较差。是否采取手术治疗能够为预测皮肤癌患者的预后提供参考。

[Purpose]To analyze the survival of hospitalized skin cancer patients in Nantong Tumor Hospital from 2008 to 2017.[Methods]The outcome information for skin cancer patients hospitalized in Nantong Tumor Hospital was traced by passive and active follow-up approach.The closing date for the follow-up was December 31,2020.The observed survival rate(OSR)was analyzed using the Kaplan-Meier method,and differences were assessed using the Log-rank test.Multivariate analysis was performed using Cox regression.A nomogram model based on risk factors for predicting survival of patients was developed by R software.The consistency index(C-index)of the Cox model and calibration curve was used to evaluate the effectiveness of the model.[Results]A total of 328 patients with skin cancer were included,including 168 males and 160 females.The 5-year OSR was 66.31%.Univariate analysis revealed that TNM staging,treatment method and tumor type significantly influenced the survival of skin cancer patients(P<0.05).Multivariate analysis identified other treatment as an independent risk factor impacting survival outcomes(P<0.05).The C-index of the nomogram model was 0.618.Fit test showed that the predictive value was very close to the actual observation value and the prediction ability of nomogram model was more accurate.[Conclusion]The 5-year OSR of skin cancer inpatients in Nantong Tumor Hospital is generally high,except for those with malignant melanoma.Not receiving proper surgical treatment is associated with poorer prognosis of skin cancer patients.