Impact of sex on the prognosis of patients with esophageal squamous cell cancer underwent definitive radiotherapy: a propensity score-matched analysis
Impact of sex on the prognosis of patients with esophageal squamous cell cancer underwent definitive radiotherapy: a propensity score-matched analysis
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DOI：
10.1186/s13014-019-1278-0
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发表时间：
2019-05-02
影响因子：
3.6
通讯作者：
Lin, Lian-Xing
中科院分区：
文献类型：
--
作者：
Luo, He-San;Xu, Hong-Yao;Lin, Lian-Xing
背景性别对接受根治性放疗的食管鳞状细胞癌（ESCC）患者预后的影响仍不清楚。本研究旨在探讨性别对接受根治性放疗的食管鳞癌患者预后的影响。方法纳入2009年1月至2015年12月在汕头市中心医院接受根治性放疗的食管鳞癌患者。使用 Kaplan-Meier 方法估计无进展生存率 (PFS) 和总生存率 (OS)。比较女性和男性患者的 PFS 和 OS。 Cox回归模型用于识别预后因素。进行倾向评分匹配分析以平衡女性和男性患者之间的基线特征。结果共纳入683例接受根治性放疗的食管鳞癌患者，其中男性497例，女性186例。在整个队列中，女性患者的中位 PFS（14.0 个月 vs 10.6 个月，P=0.0001，HR=0.688，95% CI，0.567-0.836）和 OS（20.8 个月 vs 15.9 个月，P=0.0005，HR=0.702，95% CI， 0.575-0.857）。在匹配队列中，女性患者的中位 PFS（13.5 个月 vs 11.6 个月）和 OS（19.6 个月 vs 16.1 个月）仍然显着更长。多变量分析显示，性别是PFS（HR=0.746，95% CI，0.611-0.910，P=0.004）和OS（HR=0.755，95% CI，0.615-0.926，P=0.007）的独立预后因素。结论本研究表明，性别是中国食管鳞癌患者的独立预后因素。确定的 放射治疗，女性的生存结果优于男性。应努力研究潜在的生物学机制。
BackgroundThe impact of sex on prognosis of patients with esophageal squamous cell cancer (ESCC) who underwent definitive radiotherapy remained unclear. The present study aimed to determine the impact of sex on the prognosis of patients with ESCC underwent definitive radiotherapy.MethodsBetween January 2009 and December 2015, patients with ESCC underwent definitive radiotherapy in Shantou Central Hospital were included in this study. The Progression-free survival (PFS) and overall survival (OS) rates were estimated using the Kaplan-Meier method. The PFS and OS were compared between female and male patients. The Cox regression model was used to identify prognostic factors. Propensity score-matched analysis was performed to balance baseline characteristics between female and male patients.ResultsA total of 683 ESCC patients treated with definitive radiotherapy were included, with 497 male and 186 female patients. In the whole cohort, female patients had a significantly longer median PFS (14.0months vs 10.6months, P=0.0001, HR=0.688, 95% CI, 0.567-0.836) and OS (20.8months vs 15.9months, P=0.0005, HR=0.702, 95% CI, 0.575-0.857). In the matched cohort, female patients still had a significantly longer median PFS (13.5months vs 11.6months) and OS (19.6months vs 16.1months). Multivariate analysis showed that sex was an independent prognostic factor for PFS (HR=0.746, 95% CI, 0.611-0.910, P=0.004) and OS (HR=0.755, 95% CI, 0.615-0.926, P=0.007).ConclusionsThis present study indicated that sex was an independent prognostic factor in Chinese patients with ESCC underwent definitive radiotherapy, with better survival outcome for women than men. Efforts should be made to investigate the underlying biological mechanism.