Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes
Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes
复制标题
DOI：
10.1007/s11060-016-2167-0
复制
发表时间：
2016-09-01
影响因子：
3.9
通讯作者：
Milano, Michael T.
中科院分区：
文献类型：
--
作者：
Bates, James E.;Choi, Gyujae;Milano, Michael T.
黏液性乳头状室管膜瘤是一种非常罕见的肿瘤组织学。虽然手术显然是治疗的选择，但关于辅助放疗（RT）的作用存在争议。使用监测、流行病学和最终结果（SEER）数据库，我们旨在确定MPE的流行病学、预后因素和治疗相关结局。在SEER数据库中共发现773例病例。美国人口的发病率为每百万人年1.00例。在多变量分析中，接受手术（HR = 0.14，CI = 0.06-0.35，p < 0.001），接受RT（HR = 4.06，CI = 1.87-8.81，p < 0.001），年龄<30岁（HR = 0.24，CI = 0.08-0.72，p = 0.01）和高加索人种（HR = 0.37，CI = 0.13-0.996，p = 0.049）是统计学显著的预后因素。接受RT的患者的平均肿瘤大小（4.6 cm）显著大于未接受RT的患者（3.2 cm，p = 0.0002）。那些住在大都市地区的人比那些没有的人更有可能接受RT。鉴于多项既往研究表明RT可改善PFS和肿瘤大小的差异，选择偏倚可能是RT对OS明显负面影响的重要因素。无论如何，手术仍然是MPE患者护理中最重要的方面。
Myxopapillary ependymoma (MPE) is an exceedingly rare tumor histology. While surgery is clearly the treatment of choice, controversy exists regarding the role of adjuvant radiotherapy (RT). Using the Surveillence, epidemiology, and end results (SEER) database, we aimed to determine the epidemiology, prognostic factors, and treatment-related outcomes for MPE. A total of 773 cases were found in the SEER database. The incidence in the American population was found to be 1.00 per million person-years. On multivariate analysis, receipt of surgery (HR = 0.14, CI = 0.06-0.35, p < 0.001), receipt of RT (HR = 4.06, CI = 1.87-8.81, p < 0.001), age less than 30 (HR = 0.24, CI = 0.08-0.72, p = 0.01), and Caucasian race (HR = 0.37, CI = 0.13-0.996, p = 0.049) were statistically significant prognostic factors. The mean tumor size among those receiving RT (4.6 cm) was significantly larger than among those not receiving RT (3.2 cm, p = 0.0002). Those who lived in metropolitan areas were more likely to receive RT than those who did not. Given multiple previous studies show that RT improves PFS and the discrepancy in tumor size, selection bias is likely a significant contributor to the apparent negative impact of RT on OS. Regardless, surgery remains the most crucial aspect in the care of patients with MPE.