Factors affecting risk of mortality in women with vaginal cancer.
Factors affecting risk of mortality in women with vaginal cancer.
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DOI：
10.1097/aog.0b013e31819fe844
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发表时间：
2009-05
影响因子：
7.2
通讯作者：
Li CI
中科院分区：
文献类型：
--
作者：
Shah CA;Goff BA;Lowe K;Peters WA 3rd;Li CI
评估目前人口统计学、病理学和治疗对阴道癌妇女死亡率的影响。使用来自参与监测、流行病学和最终结果（SEER）计划的17个基于人群的癌症登记处的数据，确定了1990年至2004年期间诊断为原发性阴道癌的2，149名妇女。采用考克斯比例风险模型评估各种人口统计学因素、肿瘤特征、治疗与阴道癌死亡率风险之间的关联。诊断时的平均年龄为65.7 ± 14.3岁。大约66%的病例是非西班牙裔白人。非裔美国妇女的发病率最高（1.24/10万人-年）。5年疾病特异性生存率为84%（I期）、75%（II期）和57%（III/IV期）。在多变量校正模型中，肿瘤大于4 cm和晚期疾病的女性死亡风险升高（HR分别为1.71，4.67）。与鳞状细胞癌患者相比，阴道黑色素瘤患者的死亡风险增加1.51倍（95%CI：1.07-2.41）。单纯手术治疗的死亡率最低。死亡风险随着时间的推移而下降，因为与1990-1994年的妇女相比，2000年后诊断的妇女的死亡风险调整后下降了17%。阶段，肿瘤大小，组织学和治疗方式显着影响妇女的阴道癌死亡率的风险。似乎有一个生存优势，是暂时与放化疗的到来。
To estimate the current effect of demographics, pathology, and treatment on mortality among women with vaginal cancer. Using data from 17 population-based cancer registries that participate in the Surveillance, Epidemiology, and End Results (SEER) program, 2,149 women diagnosed with primary vaginal cancer between 1990 to 2004 were identified. The association between various demographic factors, tumor characteristics, and treatments and risk of vaginal cancer mortality were evaluated using Cox proportional hazards modeling. The mean age at diagnosis was 65.7 ± 14.3 years. Approximately 66% of all cases were non-Hispanic whites. Incidence was highest among African-American women (1.24/100,000 person-years). The 5-year disease specific-survival was 84% (Stage I), 75% (Stage II), and 57% (Stage III/IV). In a multivariate adjusted model, women with tumors greater than 4 cm and advanced disease had elevated risks of mortality (HR 1.71, 4.67, respectively). Compared to women with squamous cell carcinomas, patients with vaginal melanoma had a 1.51-fold (95% CI: 1.07–2.41) increased risk of mortality. Surgery alone as a treatment modality had the lowest risk of mortality. The risk of mortality has decreased over time, as women diagnosed after 2000 had an adjusted 17% decrease in their risk of death compared to women from 1990–1994. Stage, tumor size, histology, and treatment modality significantly affect a woman’s risk of mortality from vaginal cancer. There appears to be a survival advantage that is temporally related with the advent of chemoradiation.