颅底脊索瘤患者生存因素分析

目的 分析影响颅底脊索瘤患者生存的因素。方法 收集有完善资料的颅底脊索瘤患者79例,选取性别、年龄、首发症状、阳性体征、肿瘤体积、入院前手术、入院前放疗、肿瘤部位和分期、肿瘤的质地及粘连程度、肿瘤的病理学分型、手术切除程度等可能影响颅底脊索瘤患者生存期的13个因素,用Kaplan-Meier法、Cox回归及t检验进行分析。结果 用Kaplan-Meier法单因素分析显示,肿瘤的病理学分型、入院之前曾行手术或放疗、手术切除程度、肿瘤与周围组织粘连程度是影响颅底脊索瘤患者生存期的危险因素（均P〈0．01）;Cox回归多因素分析显示肿瘤的病理学分型、入院之前行手术或放疗、手术切除程度对颅底脊索瘤患者生存期的影响具有统计学意义（均P〈0．01）。结论 结合影响颅底脊索瘤患者预后的相关因素,进一步完善包括手术技术在内的治疗手段,合理安排综合治疗的步骤,将有助于改善颅底脊索瘤患者的预后。

Factors influencing the survival of patients with skull base chordoma

OBJECTIVE: To investigate the factors influencing the survival of patients with skull base chordoma. METHODS: The clinical data of 79 patients with skull base chordoma, with a male/female ratio of 1.3:1, who received operations in Tiantan Hospital between May 1993 and June 2005 were selected. Thirteen factors, including gender, age, main symptoms, positive signs, bulk of the tumor, having received operation or radiotherapy before admission, grouping and staging of the tumor's location, and texture, adherence, pathological and resection grouping of the lesion, underwent Kaplan-Meier single factor analysis, Cox regression, and t-test. RESULTS: Kaplan-Meier single factor analysis displayed that having received operation or radiotherapy before admission, adherence, pathological and resection groupings of the lesion were the risk factors of the patients' life span (all P < 0.01). Cox multiple factor analysis showed that the all of the above factors except adherence grouping of the lesion had statistical significance on the patients' life span (all P < 0.01). CONCLUSION: Having received operation or radiotherapy before admission, adherence, pathological and resection groupings of the lesion influence the prognosis of skull base chordoma.