Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database
Gender Differences in Gastric Cancer Survival: 99,922 Cases Based on the SEER Database
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DOI：
10.1007/s11605-019-04304-y
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发表时间：
2020-08-01
影响因子：
3.2
通讯作者：
Zhang, Changhua
中科院分区：
文献类型：
--
作者：
Li, Huafu;Wei, Zhewei;Zhang, Changhua
目的探讨胃癌的性别差异及其在临床表现、病理和预后方面的差异。方法分析1973 -2013年监测流行病学和最终结果（SEER）17登记数据库中1973 - 2013年编码为原发部位“胃”的肾肿瘤。经过各种排除后，获得了99，922例具有完整数据的最终研究组。分析的人口统计学变量包括年龄、性别、婚姻状况和种族。肿瘤变量包括大小、诊断时的分期、分级、原发部位、治疗和组织学。主要结果变量包括总生存期（OS）和癌症特异性生存期（CSS）。结果：总共有96，501名胃癌患者被确定。其中34 862人（36.2%）为妇女。对于女性，对数秩检验显示男性的OS和CSS显著更长（p < 0.0001）。在考克斯回归分析中，女性与OS显著改善相关。（1973 ~ 2003年死亡的HR = 0.87，95%CI = 0.85- 0.89，P < 0.001）（2004 - 2013年死亡的HR = 0.94，95%CI = 0.91- 0.97，P < 0.001）]和癌症特异性生存[（1973 ~ 2003年死亡危险比= 0.90，95%CI = 0.87- 0.92，P < 0.001）（2004 ~ 2013年死亡危险比= 0.90，95%CI = 0.87- 0.93，P < 0.001）]。在倾向评分匹配后进行Kaplan-Meier曲线分析时，性别仍然是女性OS和CSS的显著生存因素。结论男性胃癌较女性大、分期高、分级高。女性的OS和CSS更好，这是显着不同的。
Objectives To evaluate gender differences in initial presentation, pathology and outcomes with GC (GC). Methods The 1973-2013 Surveillance Epidemiology and End Results (SEER) 17-registry database was analysed for renal tumours from 1973 to 2013 coded as primary site "stomach". After various exclusions, a final study group of 99,922 cases with complete data was obtained. Demographic variables analysed included age, sex, marital status and race. Tumour variables included size, stage at diagnosis, grade, primary site, treatment and histology. Primary outcome variables included overall survival (OS) and cancer-specific survival (CSS). Results Overall, 96,501 gastric cancer patients were identified. Of those, 34,862 (36.2%) were women. For woman, log-rank test showed that OS and CSS were significantly longer in man (p < 0.0001). In Cox regression analysis, woman was associated with a significantly improved OS [(HR of death in 1973 to 2003 = 0.87, 95% CI = 0.85-0.89,P < 0.001) (HR of death in 2004 to 2013 = 0.94, 95% CI = 0.91-0.97,P < 0.001)] and cancer-specific survival [(HR of death in 1973 to 2003 = 0.90, 95% CI = 0.87-0.92,P < 0.001) (HR of death in 2004 to 2013 = 0.90, 95% CI = 0.87-0.93,P < 0.001)]. When performing a Kaplan-Meier curve analysis after propensity score matching, gender persisted to be a significant survival of woman for OS and CSS. Conclusions Men present with larger, higher stage, higher grade GC than women. OS and CSS are better in women, which is significantly different.