Disparities of age-based cancer-specific survival improvement with various clinicopathologic characteristics for kidney cancer.
Disparities of age-based cancer-specific survival improvement with various clinicopathologic characteristics for kidney cancer.
复制标题
基于年龄的癌症特异性生存改善与肾癌的各种临床病理特征的差异。
DOI：
10.2147/cmar.s169192
复制
发表时间：
2018
影响因子：
3.3
通讯作者：
Yan S
中科院分区：
文献类型：
--
作者：
Liu K;Wang P;Zhu X;Bei Y;Zheng Z;Yan S
年龄是否是肾癌生存的预测因素目前尚不清楚，但仍存在争议。肾癌存活率的提高是否与具有特殊临床病理特征的年龄有关也是未知的。这项研究的目的是通过分析监测、流行病学和最终结果登记数据库来评估四个年龄组患者的肾癌存活率。根据性别、种族、婚姻状况、诊断年份、病理分级、组织学类型和分期，测量基于年龄的生存差异。通过多变量COX比例风险回归分析，评估年龄和其他参数对疾病特异性死亡率的影响。结果显示，49岁≤组、50-组、65-74岁组和75-84岁组的8年生存率分别为79.6%、70.6%、65.3%和56.0%。经单变量对数检验(P<；0.001)和多变量COX回归分析(P<；0.001)判断，这些差异有统计学意义。在2005-2009年确诊的患者中，基于年龄的生存改善最为明显，且具有以下临床病理特征：女性、白人、低病理分级和局部分期。在婚姻状况或组织学类型方面，基于年龄的生存改善没有明显差异。在黑人、病理IV级和远处分期的患者中，没有观察到基于年龄的生存改善(分别为P=0.05、P=0.07和P=0.07)。这些数据表明，年龄是肾癌患者生存的独立预后因素，基于年龄的生存改善与特定的临床病理特征有关。
Whether or not age is a predictor of kidney cancer survival is currently unknown but debated. It is also unknown whether improved kidney cancer survival is associated with age with particular clinicopathologic characteristics. The aim of this study was to evaluate kidney cancer survival in four age-based subgroups of patients by analyzing the Surveillance, Epidemiology, and End Results-registered database. Age-based survival disparity by sex, race, marital status, year of diagnosis, pathological grade, histological type, and stage was measured. The impact of age and further parameters on disease specific mortality was evaluated by multivariate Cox proportional hazards regression analyses. Results showed that 8-year cancer-specific survival was 79.6% in those aged ≤49 years, 70.6% in those aged 50–64 years, 65.3% in those aged 65–74 years, and 56.0% in those aged 75–84 years. These differences were significant as judged by a univariate log-rank test (P<0.001) and multivariate Cox regression (P<0.001). Age-based survival improvement was most obvious in patients diagnosed from 2005 to 2009 and with the following clinicopathologic characteristics: female, white race, low pathological grade, and localized stage. There was no obvious disparity of age-based survival improvement with regard to marital status or histologic type. No age-based survival improvement was observed in patients of the black race, pathological grade IV, or distant stage (P=0.05, P=0.07, and P=0.07, respectively). These data suggest that age is an independent prognostic factor for survival in patients with kidney cancer and that age-based survival improvement is associated with particular clinicopathologic characteristics.