Impact of age on the cancer-specific survival of patients with localized renal cell carcinoma: martingale residual and competing risks analysis.
Impact of age on the cancer-specific survival of patients with localized renal cell carcinoma: martingale residual and competing risks analysis.
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年龄对局限性肾细胞癌患者癌症特异性生存的影响：马丁格尔剩余风险和竞争风险分析
DOI：
10.1371/journal.pone.0048489
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Luo J
中科院分区：
文献类型：
--
作者：
Cai M;Wei J;Zhang Z;Zhao H;Qiu Y;Fang Y;Gao Z;Cao J;Chen W;Zhou F;Xie D;Luo J
背景：在一些研究中，诊断时的年龄已被证明是局限性肾细胞癌（RCC）的一个独立预后因素。我们使用当代统计方法重新评估年龄对局部RCC的癌症特异性生存率（CSS）的影响。方法和结果1，147例局部肾癌患者在1993年至2009年期间接受了根治性肾切除术，在我们的四个机构中进行了鉴定。估计年龄与CSS之间的关联，并通过单变量考克斯模型和鞅残差分析确定潜在阈值。竞争风险回归用于确定年龄对CSS的独立影响。中位年龄为52岁（范围：19-84岁）。存活者的中位随访时间为61个月（范围：6-144个月）。平滑鞅残差图急剧增加，表明年龄对CSS的预后有不利影响。在单变量考克斯分析和鞅残差分析中，45岁的年龄截止值是CSS的最佳预测值（p = 0.005）。 在多变量考克斯回归模型（HR = 1.59，95% CI = 1.05-2.40，p = 0.027）以及竞争风险回归（HR = 3.60，95% CI = 1.93-6.71，p = 0.001）中，年龄≤45岁与较高CSS率独立相关。 结论：年龄的增加与局部肾细胞癌的癌症特异性死亡率增加有关。年龄在45岁时二分法将最大化年龄对CSS的预测价值，并独立预测局部RCC患者的CSS。
Background Age at diagnosis has been shown to be an independent prognostic factor of localized renal cell carcinoma (RCC) in several studies. We used contemporary statistical methods to reevaluate the effect of age on the cancer-specific survival (CSS) of localized RCC. Methods and Findings 1,147 patients with localized RCC who underwent radical nephrectomy between 1993 and 2009 were identified in our four institutions. The association between age and CSS was estimated, and the potential threshold was identified by a univariate Cox model and by martingale residual analysis. Competing risks regression was used to identify the independent impact of age on CSS. The median age was 52 years (range, 19–84 years). The median follow-up was 61 months (range, 6–144 months) for survivors. A steep increasing smoothed martingale residual plot indicated an adverse prognostic effect of age on CSS. The age cut-off of 45 years was most predictive of CSS on univariate Cox analysis and martingale residual analysis (p = 0.005). Age ≤45 years was independently associated with a higher CSS rate in the multivariate Cox regression model (HR = 1.59, 95% CI = 1.05–2.40, p = 0.027) as well as in competing risks regression (HR = 3.60, 95% CI = 1.93–6.71, p = 0.001). Conclusions Increasing age was associated with a higher incidence of cancer-specific mortality of localized RCC. Age dichotomized at 45 years would maximize the predictive value of age on CSS, and independently predict the CSS of patients with localized RCC.
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影响因子：
4.5
作者：
Richstone, Lee;Bianco, Fernando J.;Scherr, Douglas S.
通讯作者：
Scherr, Douglas S.
影响因子：
1.9
作者：
Karakiewicz, Pierre. I.;Jeldres, Claudio;Patard, Jean-Jacques
通讯作者：
Patard, Jean-Jacques
影响因子：
168.9
作者：
DELAROCHEFORDIERE, A;ASSELAIN, B;FOURQUET, A
通讯作者：
FOURQUET, A
影响因子：
45.3
作者：
Mell, Loren K.;Dignam, James J.;Weichselbaum, Ralph R.
通讯作者：
Weichselbaum, Ralph R.
影响因子：
6.6
作者：
Jeong, In Gab;Yoo, Chang Hee;Kim, Choung-Soo
通讯作者：
Kim, Choung-Soo