目的验证欧洲癌症研究与治疗组织（European Organization for Research and Treatment of Cancer，EORTC）膀胱癌预后风险评分表对我国非肌层浸润性膀胱癌（non-muscle invasive bladder cancer，NMIBC）患者预后判断的准确性。方法按...目的验证欧洲癌症研究与治疗组织（European Organization for Research and Treatment of Cancer，EORTC）膀胱癌预后风险评分表对我国非肌层浸润性膀胱癌（non-muscle invasive bladder cancer，NMIBC）患者预后判断的准确性。方法按照EORTC评分标准对225例NMIBC患者进行评分并按得分高低分组，寿命表法计算每组患者的1年和5年实际复发率及进展率，LogRank检验行组间比较并与EORTC评分表相应结果对比。多因素分析筛选影响NMIBC预后的独立因素。结果低、中、高复发风险者分别32、109、84例，低、中、高进展风险者分别25、128、72例。低、中、高复发及进展风险组术后1年复发率和进展率分别为15．1％、31．2％、55．5％和0．3％、2．0％、15．5％；术后5年复发率和进展率分别为28．2％、55．2％、75．0％和1．4％、12．9％、54．7％。除高进展风险组5年进展率略高外，其余均接近EORTC评分表。各组间相比，复发率及进展率的差异有统计学意义（P〈0．01）。多因素分析表明，EORTC评分为影响NMIBC患者术后复发及进展风险的独立因素（P〈0．01）。结论EORTC风险评估表使用简便，可以按照复发及进展风险概率将患者准确分层，值得推广应用。展开更多
目的评价欧洲癌症研究与治疗组织风险评分表（European Organization for Research and Treatment of Cancerrisktables，EORTC风险评分表）用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性。方法回顾性分析2003年1月至2009年2月...目的评价欧洲癌症研究与治疗组织风险评分表（European Organization for Research and Treatment of Cancerrisktables，EORTC风险评分表）用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性。方法回顾性分析2003年1月至2009年2月收治的185例非肌层浸润性膀胱尿路上皮癌患者临床资料，其中Ta 128例、T1 57例；G1 87例、G2 53例、G3 45例；肿瘤数目为单发、2～7个、≥8个者分别120、36、29例；肿瘤直径〈3cm者131例、≥3cm者54例；伴发原位癌者6例。185例均行经尿道膀胱肿瘤电切术，术后均行常规膀胱灌注化疗。采用电话随访方式，随访6～77个月，平均36个月。应用EORTC风险评分表进行预后风险评分，计算各评分组患者的1年复发率和进展率，并与EORTC评分表的预计值进行比较。结果185例中1年内复发48例（25．9％），1年内出现肿瘤进展者7例（3．8％）。根据患者实际情况计算，0、1～4、5～9、10～17分4组患者1年实际复发率分别为10．4％（5／48）、21.5％（14／65）、35．2％（19／54）、55．6％（10／18）；0、2～6、7～13、14～23分患者1年实际进展率分别为0（0／43）、1．5％（1／67）、6．7％（4／60）、13．3％（2／15）。经Х^2检验，结果与评分表的预计值差异无统计学意义（P〉0．05）；而低危、中危、高危3组患者1年复发率及进展率差异有统计学意义（P〈0．05）。结论EORTC风险评分表可用于非肌层浸润性膀胱尿路上皮癌术后复发和进展风险的短期预测，对长期预测的应用及广泛人群的适用性尚待进一步验证。展开更多
Objective To investigate the impact of prior non-pancreatic cancer on the survival outcomes of patients with localized pancreatic neuroendocrine tumors(Pan NETs).Methods We reviewed the Surveillance,Epidemiology,and E...Objective To investigate the impact of prior non-pancreatic cancer on the survival outcomes of patients with localized pancreatic neuroendocrine tumors(Pan NETs).Methods We reviewed the Surveillance,Epidemiology,and End Results database and selected patients with localized Pan NETs diagnosed between 1973 and 2015.We divided the patients into two groups according to the presence or absence of prior non-pancreatic malignancy.Before and after propensity score matching,we compared the clinicopathological characteristics and studied the overall survival and cancer-specific survival.Results A total of 357(12.9%)of 2778 patients with localized Pan NETs had prior cancer.A total of 1211 cases with only a localized Pan NET and 133 cases with a localized Pan NET and prior cancer had complete data and met the inclusion criteria of the current study.Patients with prior cancer were associated with advanced age(>65 years,57.9%prior cancer vs.31.0%no prior cancer,P<0.001),later year of diagnosis(87.2%vs.80.2%,P=0.049),a higher proportion of poorly differentiated/undifferentiated grade tumors(4.5%vs.1.5%,P=0.025),and a higher proportion of no primary site surgery(19.5%vs.10.4%,P=0.003).Prostate(29.32%),breast(18.05%),other genitourinary and retroperitoneal(16.54%),and gastrointestinal(12.78%)cancers were the most common prior cancer types.Most of the prior cancers(95.49%)were localized and regional,and only 4.51%of the prior cancers were distant.Patients with interval periods between the prior cancer and Pan NET of≤36 months,36-60 months,60-120 months,and>120 months accounted for 33.08%,13.53%,24.06%,and 29.32%of all cases with prior cancers,respectively.Univariate and multivariate Cox proportional hazards analyses were performed.The presence/absence of prior cancers did not impact survival outcomes of patients with localized Pan NETs before and after propensity score matching(PSM).Further subgroups analysis showed that,patients with localized Pan NETs and prior distant cancer had worse cancer-specific survival than patients with prior local/regional cancer or patients without prior cancer(P<0.001).No significant differences in cancerspecific survival were observed in terms of the different sites of the prior cancers and the different interval periods of prior cancers and Pan NETs(P<0.05).Conclusions Patients with localized Pan NETs and a history of prior cancer had survival outcomes that were comparable to those of patients with no history of prior cancer.Patients with localized Pan NETs and prior cancer could be candidates for clinical trials if they satisfy all other conditions;aggressive and potentially curative therapies should be offered to these patients.展开更多
目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的...目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的效果。方法:回顾性分析2003年5月～2010年12月期间297例接受经尿道膀胱肿瘤电切(transurethral resection of bladder cancer,TURBT)的NMIBC患者的临床病理资料,所有患者均在术后24小时内接受了首次膀胱灌注化疗。按照EORTC量表的评分原则计算出每位患者的复发和进展评分,并根据得分将所有患者进行风险分层。随访各危险组患者术后复发和进展情况,并将分析结果同量表参考值比较。结果:随访时间23～115个月,平均53个月。随访过程中共122例患者(41%)复发,多因素分析显示复发性肿瘤、G2～3级肿瘤和未在TURBT后6小时内进行首次膀胱灌注化疗是复发的独立危险因素;19例患者(6%)术后进展,独立危险因素包括复发性肿瘤、T1期肿瘤、G3期肿瘤和同时存在原位癌。根据EORTC量表进行复发风险分层后,各组间实际复发率差异均有统计学意义(P<0.01);与EORTC量表参考值相比,低危组(0分)1年及5年复发率均低于参考范围;中危患者(1～9分)的1年复发率低于参考范围,而5年复发率与参考范围相近;高危组(10～17分)1年及5年复发率可信区间均包含EORTC量表的参考范围。进展风险分层除低危组(0分)与中低危组(2～6分)间的实际进展率差异无统计学意义(P=0.10)外,其它各组间的差异均有统计学意义(P<0.01);各风险组实际进展率均接近EORTC的参考范围。结论:EORTC量表对于接受术后即刻膀胱灌注化疗的中国NMIBC患者具有预后价值,但低危患者的实际复发率和中危患者的短期实际复发率低于该量表的参考值。展开更多
文摘目的验证欧洲癌症研究与治疗组织（European Organization for Research and Treatment of Cancer，EORTC）膀胱癌预后风险评分表对我国非肌层浸润性膀胱癌（non-muscle invasive bladder cancer，NMIBC）患者预后判断的准确性。方法按照EORTC评分标准对225例NMIBC患者进行评分并按得分高低分组，寿命表法计算每组患者的1年和5年实际复发率及进展率，LogRank检验行组间比较并与EORTC评分表相应结果对比。多因素分析筛选影响NMIBC预后的独立因素。结果低、中、高复发风险者分别32、109、84例，低、中、高进展风险者分别25、128、72例。低、中、高复发及进展风险组术后1年复发率和进展率分别为15．1％、31．2％、55．5％和0．3％、2．0％、15．5％；术后5年复发率和进展率分别为28．2％、55．2％、75．0％和1．4％、12．9％、54．7％。除高进展风险组5年进展率略高外，其余均接近EORTC评分表。各组间相比，复发率及进展率的差异有统计学意义（P〈0．01）。多因素分析表明，EORTC评分为影响NMIBC患者术后复发及进展风险的独立因素（P〈0．01）。结论EORTC风险评估表使用简便，可以按照复发及进展风险概率将患者准确分层，值得推广应用。
文摘目的评价欧洲癌症研究与治疗组织风险评分表（European Organization for Research and Treatment of Cancerrisktables，EORTC风险评分表）用于非肌层浸润性膀胱尿路上皮癌患者预后评估的可行性。方法回顾性分析2003年1月至2009年2月收治的185例非肌层浸润性膀胱尿路上皮癌患者临床资料，其中Ta 128例、T1 57例；G1 87例、G2 53例、G3 45例；肿瘤数目为单发、2～7个、≥8个者分别120、36、29例；肿瘤直径〈3cm者131例、≥3cm者54例；伴发原位癌者6例。185例均行经尿道膀胱肿瘤电切术，术后均行常规膀胱灌注化疗。采用电话随访方式，随访6～77个月，平均36个月。应用EORTC风险评分表进行预后风险评分，计算各评分组患者的1年复发率和进展率，并与EORTC评分表的预计值进行比较。结果185例中1年内复发48例（25．9％），1年内出现肿瘤进展者7例（3．8％）。根据患者实际情况计算，0、1～4、5～9、10～17分4组患者1年实际复发率分别为10．4％（5／48）、21.5％（14／65）、35．2％（19／54）、55．6％（10／18）；0、2～6、7～13、14～23分患者1年实际进展率分别为0（0／43）、1．5％（1／67）、6．7％（4／60）、13．3％（2／15）。经Х^2检验，结果与评分表的预计值差异无统计学意义（P〉0．05）；而低危、中危、高危3组患者1年复发率及进展率差异有统计学意义（P〈0．05）。结论EORTC风险评分表可用于非肌层浸润性膀胱尿路上皮癌术后复发和进展风险的短期预测，对长期预测的应用及广泛人群的适用性尚待进一步验证。
基金funded by the National Natural Science Foundation of China-Youth Fund(81702855)the National Natural Science Foundation of China(81672862)。
文摘Objective To investigate the impact of prior non-pancreatic cancer on the survival outcomes of patients with localized pancreatic neuroendocrine tumors(Pan NETs).Methods We reviewed the Surveillance,Epidemiology,and End Results database and selected patients with localized Pan NETs diagnosed between 1973 and 2015.We divided the patients into two groups according to the presence or absence of prior non-pancreatic malignancy.Before and after propensity score matching,we compared the clinicopathological characteristics and studied the overall survival and cancer-specific survival.Results A total of 357(12.9%)of 2778 patients with localized Pan NETs had prior cancer.A total of 1211 cases with only a localized Pan NET and 133 cases with a localized Pan NET and prior cancer had complete data and met the inclusion criteria of the current study.Patients with prior cancer were associated with advanced age(>65 years,57.9%prior cancer vs.31.0%no prior cancer,P<0.001),later year of diagnosis(87.2%vs.80.2%,P=0.049),a higher proportion of poorly differentiated/undifferentiated grade tumors(4.5%vs.1.5%,P=0.025),and a higher proportion of no primary site surgery(19.5%vs.10.4%,P=0.003).Prostate(29.32%),breast(18.05%),other genitourinary and retroperitoneal(16.54%),and gastrointestinal(12.78%)cancers were the most common prior cancer types.Most of the prior cancers(95.49%)were localized and regional,and only 4.51%of the prior cancers were distant.Patients with interval periods between the prior cancer and Pan NET of≤36 months,36-60 months,60-120 months,and>120 months accounted for 33.08%,13.53%,24.06%,and 29.32%of all cases with prior cancers,respectively.Univariate and multivariate Cox proportional hazards analyses were performed.The presence/absence of prior cancers did not impact survival outcomes of patients with localized Pan NETs before and after propensity score matching(PSM).Further subgroups analysis showed that,patients with localized Pan NETs and prior distant cancer had worse cancer-specific survival than patients with prior local/regional cancer or patients without prior cancer(P<0.001).No significant differences in cancerspecific survival were observed in terms of the different sites of the prior cancers and the different interval periods of prior cancers and Pan NETs(P<0.05).Conclusions Patients with localized Pan NETs and a history of prior cancer had survival outcomes that were comparable to those of patients with no history of prior cancer.Patients with localized Pan NETs and prior cancer could be candidates for clinical trials if they satisfy all other conditions;aggressive and potentially curative therapies should be offered to these patients.
文摘目的:验证和研究欧洲癌症研究与治疗组织(European Organization for Research and Treatment of Cancer,EORTC)风险量表对我国接受术后即刻膀胱灌注化疗的非肌层浸润性膀胱癌(nonmuscle invasive bladder cancer,NMIBC)患者预后判断的效果。方法:回顾性分析2003年5月～2010年12月期间297例接受经尿道膀胱肿瘤电切(transurethral resection of bladder cancer,TURBT)的NMIBC患者的临床病理资料,所有患者均在术后24小时内接受了首次膀胱灌注化疗。按照EORTC量表的评分原则计算出每位患者的复发和进展评分,并根据得分将所有患者进行风险分层。随访各危险组患者术后复发和进展情况,并将分析结果同量表参考值比较。结果:随访时间23～115个月,平均53个月。随访过程中共122例患者(41%)复发,多因素分析显示复发性肿瘤、G2～3级肿瘤和未在TURBT后6小时内进行首次膀胱灌注化疗是复发的独立危险因素;19例患者(6%)术后进展,独立危险因素包括复发性肿瘤、T1期肿瘤、G3期肿瘤和同时存在原位癌。根据EORTC量表进行复发风险分层后,各组间实际复发率差异均有统计学意义(P<0.01);与EORTC量表参考值相比,低危组(0分)1年及5年复发率均低于参考范围;中危患者(1～9分)的1年复发率低于参考范围,而5年复发率与参考范围相近;高危组(10～17分)1年及5年复发率可信区间均包含EORTC量表的参考范围。进展风险分层除低危组(0分)与中低危组(2～6分)间的实际进展率差异无统计学意义(P=0.10)外,其它各组间的差异均有统计学意义(P<0.01);各风险组实际进展率均接近EORTC的参考范围。结论:EORTC量表对于接受术后即刻膀胱灌注化疗的中国NMIBC患者具有预后价值,但低危患者的实际复发率和中危患者的短期实际复发率低于该量表的参考值。
