Clinicopathological features and prognosis factors for survival in elderly patients with pancreatic neuroendocrine tumor: A STROBE-compliant article
Clinicopathological features and prognosis factors for survival in elderly patients with pancreatic neuroendocrine tumor: A STROBE-compliant article
复制标题
老年胰腺神经内分泌肿瘤患者的临床病理特征和生存预后因素：一篇符合 STROBE 标准的文章
DOI：
10.1097/md.0000000000014576
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发表时间：
2019-03-01
期刊：
影响因子：
1.6
通讯作者：
Xiu, Dian-rong
中科院分区：
文献类型：
--
作者：
Li, Gang;Tian, Mao-lin;Xiu, Dian-rong
为了解老年胰腺神经内分泌肿瘤（pNET）患者的临床特征及预后，对2004 - 2014年期间确诊的pNET患者进行流行病学监测和最终结果分析。由于本研究是对监测流行病学和最终结果数据库的数据进行分析，共有4608例患者确诊为原发性仅组织学pNET，其中653例年龄大于75岁。检查癌症特异性生存期（CSS）和总生存期（OS）。与年轻队列相比，老年患者（75岁）的CSS和OS处于劣势。多因素Logistic回归分析显示，老年患者的低分化构成增加，黑人患者比例、接受手术、已婚状态和淋巴结切除数量减少。多元考克斯回归分析显示分化较差。T3-4期和M1期患者的CSS较差，而女性、肿瘤位于胰体尾、接受过手术、已婚患者的CSS较好。同时，组织学分级和M1分期越高的患者OS越差，而女性、已婚、肿瘤位于胰体尾和肿瘤手术的患者OS越好。远处转移的老年患者行原发部位手术的CSS和OS均优于未手术的患者。老年患者低分化肿瘤的可能性增加，黑人患者比例、原发部位手术、淋巴结切除数、已婚者比例均下降。肿瘤分化差、肿瘤转移是CSS和OS的独立危险因素，而肿瘤位于胰体尾、女性、原发灶手术、已婚是CSS和OS的保护因素。
To investigate the features and prognosis of the elderly patients with pancreatic neuroendocrine tumor (pNET).The patients diagnosed with pNETs between 2004 and 2014 were identified from the Surveillance Epidemiology and End Results database. The ethical approval was waived because the present study was analysis of the data from Surveillance Epidemiology and End Results database.A total of 4608 patients with one primary only histologically pNETs were confirmed and 653 were older than 75 years. Cancer-specific survival (CSS) and overall survival (OS) were examined. The elderly patients (75 years) have disadvantage in CSS and OS compared with younger cohort. Multivariate logistic regression revealed that the elderly patients have increased poorly differentiated composition, and decreased proportion of Black patients, receipt of surgery, married status, and number of removed lymph node. Multivariate Cox regression analysis demonstrated worse differentiation. Patients of T3-4 and M1 stage were associated with poor CSS, while patients of being female, tumor locating at pancreatic body/tail, receipt of surgery, and being married were associated with better CSS in the elderly patients. Meanwhile, patients with higher histological grade and M1 stage have poor OS, while patients with the characteristics of female, being married, tumor location at pancreatic body/tail and tumor surgery have better OS. Distant metastatic elderly patients underwent primary site surgery had better CSS and OS than the patients without surgery.The elderly patients have increased possibility of poorly differentiated tumor, and decreased proportion of Black patients, surgery of primary site, number of removed lymph node and married status. Worse differentiation and tumor metastasis were independent risk factors for both CSS and OS, while primary tumor located in body/tail of pancreas, female patients, surgery of tumor primary site, and being married were protective factors.