Effect of menopausal status on the survival and recurrence of sex-classified hepatocellular carcinoma after liver resection: a case-matched study with propensity score matching.
Effect of menopausal status on the survival and recurrence of sex-classified hepatocellular carcinoma after liver resection: a case-matched study with propensity score matching.
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绝经状态对性别分类肝细胞癌肝切除术后生存和复发的影响：倾向评分匹配的病例匹配研究
DOI：
10.18632/aging.202155
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发表时间：
2020-11-24
期刊：
影响因子：
--
通讯作者：
Liu H
中科院分区：
文献类型：
--
作者：
Zhang W;Liu F;Huang J;Guo X;Dong W;Wei S;Li L;Zhu X;Zhou W;Liu H
目的：探讨绝经状态对性别分类的肝细胞癌（HCC）预后的影响，并建立肝切除术后患者的预后诺模图。结果如下：在倾向评分匹配（PSM）后，发现男性和女性HCC患者的总生存期（OS）和无复发生存期（RFS）存在统计学显著差异。根据考克斯回归分析，这些差异在男性患者扩展的正常月经（N）组中明显，但在扩展的绝经后（P）或中间（I）组中均不明显。性别差异在所有HCC患者的无复发生存期（RFS）中也很明显。合并独立因素后，扩展N组的OS和RFS列线图的C指数分别为0.773和0.724，高于总患者数和BCLC分期列线图的C指数（P<0.001）。结论：性别差异仅在月经正常的女性及其配对的男性中影响肝癌的生存和复发。对于预测生存率，来自扩大的N组HCC患者的预后列线图对于具有相同临床条件的患者更准确。方法：对2008年至2012年期间因HCC接受根治性肝切除术的患者（390名女性和1920名男性）进行筛选。390名妇女被分为三组：月经正常，中期和绝经后。为了克服选择偏差，三组女性与男性以1：2的比例匹配，使用倾向评分匹配。基于进一步的考克斯回归分析，通过R rms将独立因素整合到OS和RFS的列线图中。通过C指数、校准曲线和决策曲线分析评价列线图的准确性和区分度。
Objective: To investigate the impact of menopausal status on the prognosis for sex-classified Hepatocellular carcinoma (HCC) and to establish prognostic nomograms for patients after liver resection. Results: After propensity score matching (PSM), statistically significant differences in both overall survival (OS) and recurrence-free survival (RFS) were found between men and women HCC patients. Based on Cox regression analysis, these differences were evident in the normal menstruation (N) group expanded with male patients, but not in either the expanded postmenopausal (P) or intermediate (I) groups. Sex disparity was also apparent in the recurrence-free survival (RFS) of the total HCC patients. Integrated with independent factors, nomograms for the OS and RFS of the expanded N group showed higher C-indices of 0.773 and 0.724, respectively, than those of nomograms for the total patients and BCLC stage (P<0.001). Conclusion: Sex disparity appears to affect both the survival and recurrence of HCC only in normal menstruation women and their matched men. For predicting survival, prognostic nomograms derived from the expanded N group of HCC patients were more accurate for patients with the same clinical conditions. Methods: The patients (390 females and 1920 males), who underwent curative liver resection for HCC during 2008 to 2012, were screened. The 390 women were divided into three groups: normal menstruation, intermediate, and postmenopausal. To overcome selection bias, the three groups of females were matched with males at a ratio of 1:2, using propensity score matching. Based on further Cox regression analysis, independent factors were integrated into nomograms for OS and RFS by R rms. The accuracy and discrimination of the nomograms were evaluated by the C-index, calibration curve, and decision curve analysis.
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影响因子：
29.4
作者：
El-Serag HB
通讯作者：
El-Serag HB
影响因子：
3.1
作者：
Ladenheim MR;Kim NG;Nguyen P;Le A;Stefanick ML;Garcia G;Nguyen MH
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Nguyen MH
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Han, Ho-Seong;Shehta, Ahmed;Choi, YoungRok
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Choi, YoungRok
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3.6
作者：
BREIDBART, S;BURK, RD;SAENGER, P
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SAENGER, P
影响因子：
45.3
作者：
Grimaldi, C;Bleiberg, H;Wils, J
通讯作者：
Wils, J