多发恶性肿瘤次原发食管癌的生存预后分析:基于人群的分析

Survival prognosis of multiple malignant tumors with secondary primary esophageal cancer:a population-based analysis

目的 探讨次原发食管癌(SPE)易发因素及影响其预后的相关因素。方法 选取监测/流行病学和最终结果(SEER)数据库中,2000~2019年病理诊断明确食管癌病人,并从中筛选出以其他恶性肿瘤为首发,食管癌为次原发(secondary primary esophageal cancer-SPE)的病人资料,采用Logistic回归分析SPE发生的独立危险因素,并利用Cox比例风险分析影响预后的独立危险因素。结果 多原发恶性肿瘤伴食管癌病人13 520例,经筛选后SPE病人8 308例。Logistic多因素分析显示,年龄、肿瘤部位、肿瘤分化程度、病理学结果、SEER肿瘤侵犯程度及区域淋巴结的采取情况是影响发生SPE的独立因素,Cox多因素分析提示,年龄、确诊年限、种族、肿瘤分化程度、SEER肿瘤侵犯程度、手术、化疗、放疗及三联疗法均为影响SPE的独立危险因素。结论 年龄、确诊年限、种族、肿瘤分化程度、SEER肿瘤侵犯程度、手术、化疗、放疗及三联疗法是SPE发生的危险因素,手术可能是治疗的有效方式。

Objective To investigate the predisposing factors carried out in patients with secondary primary esophageal cancer and the related factors affecting its prognosis.Methods Patients with pathologically definite esophageal cancer diagnosis from 2000-2019 in the Surveillance/Epidemiology and End Results(SEER)database were selected,from which the data of patients with other malignancies as the first and esophageal cancer as the second primary(Secondary Primary Esophageal cancer-SPE)were screened,and logistic regression was used to analyze the independent risk factors in patients with secondary primary esophageal cancer,and the independent risk factors affecting the prognosis of such patients were analyzed by Cox proportional hazard model.Results A total of 13520 patients with multiple primary malignancies with esophageal cancer,including a total of 8308 patients with secondary primary esophageal cancer.Multiple logistic analysis showed that age,tumor site,tumor differentiation,pathological examines,SEER neoplasm invasiveness and regional lymph node adoption were independent factors influencing the occurrence of SPE,while multiple Cox risk proportion analysis suggested that age,year of diagnosis,race,tumor differentiation,SEER neoplasm invasiveness,surgery,chemotherapy,radiotherapy,and triple therapy were independent risk factors influencing SPE.Conclusion This study identified risk factors for secondary primary esophageal cancer,and surgery may be an effective treatment for SPE,which clinicians can use as a reference for diagnosis and treatment.