Prognosis and treatment of uterine leiomyosarcoma: A National Cancer Database study
Prognosis and treatment of uterine leiomyosarcoma: A National Cancer Database study
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DOI：
10.1016/j.ygyno.2017.02.012
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发表时间：
2017-04-01
影响因子：
4.7
通讯作者：
Shahabi, Shohreh
中科院分区：
文献类型：
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作者：
Seagle, Brandon-Luke L.;Sobecki-Rausch, Janelle;Shahabi, Shohreh
目标。目的：探讨子宫肌肉瘤患者的总体生存率及其影响因素。我们对1998-2013年国家癌症数据库中的7455名患有子宫平滑肌肉瘤的妇女进行了一项观察性队列研究。采用Kaplan-Meier和多变量加速失效时间生存分析来研究生存的预测因素。通过敏感性和配对队列分析，评估卵巢切除、淋巴清扫和化疗在早期平滑肌肉瘤中的作用，以及化疗在转移性平滑肌肉瘤中的作用。确诊时的中位年龄(四分位数范围)为54岁(48-63岁)。不匹配的队列分析显示，年龄较大、合并症较高、黑人、分期或分级较高、肿瘤较大、淋巴结转移、确诊时转移、手术切缘阳性、辅助化疗和近距离放射治疗与生存率下降独立相关。私人保险与提高存活率有关。根据匹配的队列分析，在女性中，省略卵巢切除术与生存无关。
Objective. To determine overall survival and factors associated with survival of women with uterine leiomyosarcoma.Methods. We performed an observational cohort study of women with uterine leiomyosarcoma (n = 7455) from the 1998-2013 National Cancer Database. Kaplan-Meier and multivariable accelerated failure time survival analyses were performed to investigate predictors of survival. Sensitivity and matched cohort analyses were performed to evaluate the roles of oophorectomy, lymphadenectomy, and chemotherapy in early leiomyosarcoma and chemotherapy in metastatic leiomyosarcoma.Results. Median (interquartile range) age at diagnosis was 54 (48-63) years. Older age, higher comorbidity, black race, higher stage or grade, larger tumor size, lymph node involvement, metastasis at diagnosis, positive surgical margin, adjuvant chemotherapy, and brachytherapy were independently associated with decreased survival by unmatched cohort analyses. Private insurance was associated with increased survival. By matched cohort analyses, omitting oophorectomy was not associated with survival among women