Ⅲ期小细胞肺癌年轻患者的肿瘤特异性生存优势

目的 考察年龄对小细胞肺癌(SCLC)患者预后评估的价值。 方法 登陆监测、流行病学及最终结果(SEER)登记系统,查询2010年1月至2013年12月的所有SCLC病例(n=17 237)。青年组定义为年龄≤49岁的患者(n=733),中年组定义为50~64岁的患者(n=6 332),老年组定义为年龄≥65岁的患者(n=10 172)。分析各组患者的临床病理特征,获取肿瘤特异性生存(CSS)等数据,应用Kaplan-Meier法及多变量Cox回归模型进行统计分析。 结果 单因素及多因素分析均显示,随着年龄的增加,CSS缩短(χ2=342.08, P<0.001),其中青年组患者的OS(χ2=203.90, P<0.001)和CSS(χ2=160.50, P<0.001)均提高。中年组风险比(HR)为1.177(95%CI:1.068~1.296, P=0.001),老年组HR为1.643(95%CI:1.495~1.807, P<0.001)。在Ⅰ期(P=0.015)、Ⅲ期(P<0.001)、Ⅳ期(P<0.001)或接受非手术治疗(P<0.001)的患者中,年龄越小,CSS越具优势。 结论 年龄≤49岁的SCLC患者较更年长患者具有生存优势;在Ⅲ期及接受非手术治疗的患者中,年龄具有较明确的预后价值。

Tumor-specific survival advantage in young patients with stage Ⅲ small cell lung cancer

Objective To estimate the prognostic value of age on small cell lung cancer(SCLC)patients. Methods The Surveillance, Epidemiology, and End Results(SEER)population-based data was queried for SCLC patients from Jan. 2010 to Dec. 2013, and 17 237 cases were enrolled. The cases ≤ 49 years were defined as young group(n=733), 50-64 years were defined as middle-aged group(n=6 332), and the cases ≥ 65 years were defined as elderly group(n=10 172). Clinicopathological characteristics of patients were analyzed. Cancer-specific survival(CSS)data were obtained. The analysis of CSS outcomes and risk factors were analyzed by Kaplan-Meier methods and multivariable Cox regression model. Results Both univariate and multivariate analyses showed that CSS significantly decreased with advanced ages(χ2=342.08, P<0.001). The OS(χ2=203.9, P<0.001)and CSS(χ2=160.5, P<0.001)of the young group were improved. In middle-aged group, hazard ratio(HR)was 1.177(95%CI: 1.068-1.296, P=0.001); in elderly group, HR was 1.643(95%CI: 1.495-1.807, P<0.001). Smaller age guaranteed a significantly improved CSS in patients who were at stages Ⅰ(P=0.015), Ⅲ(P<0.001), Ⅳ(P<0.001)or underwent non-surgical treatment(P<0.001). Conclusion Compared to older patients, the SCLC patients ≤49 years hold advantages in both OS and CSS. The prognostic value of age is more exact in patients at stage Ⅲ or managed non-operatively.