基于SEER数据库的恶性腹膜间皮瘤患者生存分析

Survival analysis of patients with malignant peritoneal mesothelioma based on SEER database

目的基于监测、流行病学和最终结果(SEER)数据库分析恶性腹膜间皮瘤(MPM)患者生存结局及预后影响因素。方法回顾性分析2004-2017年SEER数据库中被确诊为MPM患者人口学特征、临床病理资料及肿瘤特异性生存率(CSS),并对其预后影响因素进行单因素及多因素Cox回归分析。结果516例MPM患者1、3、5年CSS分别为55.7%、32.9%、27.6%。95例MPM患者的单因素Cox回归分析显示,≥65岁、男性、纤维肉瘤型、中分化、低分化、未分化、肿瘤远处转移、手术是影响MPM患者生存率的危险因素(P<0.05)。不同年龄、性别、病理组织类型、病理分级、SEEER综合分期及是否手术的MPM患者累积生存率比较,差异有统计学意义(P<0.05)。多因素Cox回归分析显示,纤维肉瘤型(P=0.036)、中等分化(P=0.012)、低分化(P<0.001)、未分化(P<0.001)、肿瘤远处转移(P=0.005)、化疗(P=0.010)是MPM患者预后的独立危险因素。结论MPM患者预后与肿瘤病理类型、病理分级、SEER综合分期及是否化疗有关。

Objective To analyze the survival outcomes and prognostic factors of patients with malignant peritoneal mesothelioma(MPM)based on the Surveillance,Epidemiology,and End Results(SEER)database.Methods A retrospective analysis of demographic characteristics,clinicopathological data,a nd cancer-specific survival(CSS)rates of the patients diagnosed with MPM from 2004 to 2017 in the SEER database was conducted.Prognostic factors were assessed using univariate and multivariate Cox regression analyses.Results Amon g 516 MPM patients,the 1-,3-,and 5-year CSS rates were 55.7%,32.9%,and 27.6%,respectively.Univariate Cox regression analysis of 95 MPM patients indicated that age≥65 years,male sex,sarcomatoid subtype,moderate differentiation,poor differentiation,undifferentiated tumors,distant metastasis,and absence of surgery were significant risk factors affecting patient survival(P<0.05).Comparison of cumulative survival rates among MPM patients stratified by different ages,sexes,histological subtypes,pathological grades,SEER stage,and surgical status showed statistically significant differences(P<0.05).Multivariate Cox regression analysis revealed that sarcomatoid subtype(P=0.036),moderate differentiation(P=0.012),poor differentiation(P<0.001),undifferentiated tumors(P<0.001),distant metastasis(P=0.005),and chemotherapy(P=0.010)were independent adverse prognostic factors for the MPM patients.Conclusion Prognosis of MPM patients is associated with tumor histological subtype,pathological grade,SEER stage,and chemotherapy status.