基于SEER数据库对不同分期阑尾癌患者的预后分析

Prognostic Analysis of Patients withDifferent Stages of Appendiceal CancerBased on SEER Database

目的:探究各分期阑尾癌患者的生存预后,并根据各项临床病理参数分析其预后预测价值。方法:应用美国SEER数据库中自2010年至2015年,接受阑尾切除手术且术后确诊为阑尾癌的患者共5176例。根据所收集的患者信息,分别采取单因素及多因素Cox回归来分析影响阑尾癌患者预后的主要因素;并使用Kaplan-Meier法绘制生存曲线;Log-rank检验分析来比较生存率差异。结果:文中所收集患者的5年总体生存率为64.68%,中位生存时间为58个月,平均生存时间为57月。四分期的五年生存率表现为90.3%(I期)、74.2% (II期)、59.1% (III期)、35.1% (IV期);多因素Cox回归分析显示,性别(95%CI: 1.052~1.361,P = 0.006)、诊断年龄(95%CI: 1.128~1.722;P < 0.001)、人种(95%CI: 1.018~1.266;P = 0.023)、邻近 器官有无受累(95%CI: 0.015~0.124;P < 0.001)、分化程度(95%CI: 0.848~1.098;P < 0.001)、T (95%CI: 0.565~0.815;P < 0.001)、N (95%CI: 1.783~2.216;P < 0.001)、M (95%CI: 1.663~2.261;P < 0.001)、切除局部淋巴结数(95%CI: 0.336~0.918;P = 0.009)是影响阑尾癌患者生存预后的独立因素。 结论:伴随着TNM分期的增高,阑尾癌根治手术患者的总体生存率是逐渐降低的。性别、诊断年龄、人 种、分化程度、邻近器官有无受累、T、N、M及局部切除淋巴结数等参数是评估阑尾癌根治手术患者生 存预后的独立指标,为临床上不同分期阑尾癌患者预后的分析提供参考。

Objective: To investigate the prognosis of patients with appendiceal cancer at different stages andanalyze the prognostic value of clinicopathological parameters. Methods: A total of 5176 patientswith appendiceal cancer who underwent appendectomy from 2010 to 2015 were collected bySEER software in the United States, and the prognostic factors of colorectal cancer patients wereanalyzed by univariate and multivariate Cox regression analysis, the survival curve of patientswas drawn by Kaplan-Meier method, and the difference of survival rate was analyzed by Log-ranktest. Results: The 5-year overall survival rate of 5176 patients with appendiceal cancer was 64.68%,the median survival time was 58 months, and the average survival time was 57 months. The 5-yearsurvival rates of stage I, II, III, and IV were 90.3%, 74.2%, 59.1%, and 35.1%, respectively. MultivariateCox regression analysis showed that gender (95%CI: 1.052~1.361;P = 0.006), age at diagnosis(95%CI: 1.128~7.722;P < 0.001), race (95%CI: 1.018~1.266;P = 0.023) , differentiation degree (95%CI: 0.848~1.098;P < 0.001), adjacent organ involvement (95%CI: 0.015~0.124;P < 0.001), T (95%CI: 0.565~0.815;P < 0.001), N (95%CI: 1.783~2.216;P < 0.001), M (95%CI: 1.663~2.261;P < 0.001), and the number of resected local lymph nodes (95%CI: 0.336~0.918;P = 0.009) were independent factors affecting the survival prognosis of patients with appendiceal cancer. Conclusions: With the increase of TNM stage I, II, III, and IV, the overall survival rate of patients with appendiceal cancer after radical surgery gradually decreases. In addition, gender, age at diagnosis, race, differentiation, involvement of adjacent organs, T, N, M, and the number of locally resected lymph nodes are independent indicators for evaluating the survival prognosis of patients with appendiceal cancer after radical surgery, which provides a reference for the prognosis analysis of patients with different stages of appendiceal cancer.