A Population-Based Analysis of Distant Metastasis in Stage IV Gastric Cancer
A Population-Based Analysis of Distant Metastasis in Stage IV Gastric Cancer
复制标题
IV 期胃癌远处转移的人群分析
DOI：
10.12659/msm.923867
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发表时间：
2020-05-15
影响因子：
3.1
通讯作者：
Wang, Xin
中科院分区：
文献类型：
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作者：
Zhang, Yiran;Lin, Yile;Wang, Xin
背景 远处转移（DM）是胃癌患者治疗中的一个关键问题。识别糖尿病发展的危险因素和糖尿病患者的预后因素对于发展具有特定转移的晚期患者的个体化治疗至关重要。材料/方法 从监测、流行病学和最终结果 (SEER) 数据库中提取胃癌患者的记录。估计特定糖尿病患者的生存时间，并使用 Cox 比例风险回归模型研究预后因素。使用逻辑回归模型揭示DM发展的内在危险因素。结果最终，2010年至2015年间，32.6%的胃癌患者（36,588例中的11,918例）被诊断为DM，其中分别有5,361例、1,778例、1,495例和231例患者被诊断为肝转移、肺转移、骨转移和脑转移。糖尿病患者的中位总生存期为 5.0（95% CI：4.8-5.2）个月，5 年生存率为 3.9%。原发肿瘤部位、组织学类型、肿瘤分级、T分期、N分期、手术、化疗和转移数量与较差的生存率相关。年龄较小和肿瘤分级较高与 DM 的发生呈正相关。结论 32.6%的胃癌患者存在初发糖尿病。针对特定转移部位的患者确定同质和异质预测因素，可用于针对性筛查和个体化治疗。
Background Distant metastasis (DM) is a crucial problem in management of patients with gastric cancer. Identification of the risk factors for development of DM and the prognostic factors for patients with DM is essential in development of individualized treatment of patients at the advanced stage with specific metastasis. Material/Methods Records of patients with gastric cancer were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Survival duration of patients with specific DM was estimated, and the prognostic factors were investigated using the Cox proportional hazard regression model. The logistic regression model was used to reveal the inherent risk factors for development of DM. Results Eventually, 32.6% (11,918 out of 36,588) of gastric cancer patients were diagnosed with DM between 2010 and 2015, among whom 5,361, 1,778, 1,495, and 231 patients were diagnosed with liver, lung, bone, and brain metastasis, respectively. The median overall survival for patients with DM was 5.0 (95% CI: 4.8–5.2) months, with a 5-year survival rate of 3.9%. Primary tumor site, histology types, tumor grade, T stage, N stage, surgery, chemotherapy, and the number of metastases were associated with worse survival. Younger age and higher tumor grade were positively associated with the development of DM. Conclusions Initial DM was found in 32.6% of patients with gastric cancer. Homogenous and heterogenous predictive factors were identified for patients with a specific metastatic site, which can be used in targeted screening and individualized treatment.