Analysis of Prognostic Factors in Ewing Sarcoma Using a Population-Based Cancer Registry
Analysis of Prognostic Factors in Ewing Sarcoma Using a Population-Based Cancer Registry
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DOI：
10.1002/cncr.24937
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发表时间：
2010-04-15
期刊：
影响因子：
6.2
通讯作者：
Zell, Jason A.
中科院分区：
文献类型：
--
作者：
Lee, Joe;Hoang, Bang H.;Zell, Jason A.
背景：尤文肉瘤是一种高度恶性肿瘤，最常发生在儿童。由于其在成人中的发生率一直很低，很少有关于尤文肉瘤在这组患者中的流行病学研究发表。通过使用来自一个大型的、以人群为基础的癌症登记处的数据，作者设计了本研究，以检查尤文肉瘤儿童和成人患者的结局以及相关的预后因素。方法：对加州癌症登记数据库中的尤文肉瘤患者病例进行了回顾性分析，以确定1989-2007年间诊断的偶发患者病例。进行比较，以检查人口统计学，疾病特征，治疗和生存的差异。生存分析采用Kaplan-Meier法结合对数秩检验和考克斯比例风险模型进行。结果：共发现725例尤文肉瘤病例，其中儿童372例（51.3%），成人353例（48.7%）。西班牙裔与年轻（P = 0.001）和较低的社会经济地位（SES; P= 0.0001）相关。盆腔受累与肿瘤较大（>8 cm; P < .0001）、转移发生率增加（P < .0002）和生存率降低（P < .0001）相关。在调整临床相关因素后，成人患者的总生存率在统计学上显著降低（风险比[HR]，1.71; 95%置信区间[Cl]，1.35-2.17），西班牙裔（HR，1.33; 95% CI，1.01-1.75）、转移性疾病（HR，2.74; 95% CI，2.14-3.49）、肿瘤尺寸大（HR，1.65; 95% CI，1.17-2.34）、未手术治疗和低SES。结论：作者确定，成年年龄、西班牙人种、转移性疾病、大肿瘤大小和低SES是尤文肉瘤患者病例总生存率的不良预后因素。Cancer 2010;116：1964-73. (C)2010美国癌症协会
BACKGROUND: Ewing sarcoma is a high-grade malignancy that most often occurs in children. Because its occurrence in adults has been historically low, few studies have been published on the epidemiology of Ewing sarcoma in this group of patients. By using data from a large, population-based cancer registry, the authors designed the present study to examine the outcome of children and adult patients with Ewing sarcoma and relevant prognostic factors. METHODS: A retrospective analysis of Ewing sarcoma patient cases in the California Cancer Registry database was performed to identify incident patient cases diagnosed between 1989-2007. Comparisons were made to examine differences in demographics, disease characteristics, treatment, and survival. Survival analyses were performed using Kaplan-Meier method with log-rank tests and Cox proportional hazards models. RESULTS: Seven hundred and twenty-five incident patient cases of Ewing sarcoma were identified, including 372 (51.3%) children and 353 (48.7%) adults. Hispanic race was associated with young age (P = .001) and lower socioeconomic status (SES; P=.0001). Pelvic involvement was associated with large tumor size (>8 cm; P < .0001), an increased incidence of metastasis (P < .0002), and poorer survival (P < .0001). After adjusting for clinically relevant factors, statistically significant decreased overall survival was seen with adults (hazard ratio [HR], 1.71; 95% confidence interval [Cl), 1.35-2.17), Hispanics (HR, 1.33; 95% Cl, 1.01-1.75), metastatic disease (HR, 2.74; 95% Cl, 2.14-3.49), large tumor size (HR, 1.65; 95% Cl, 1.17-2.34), no surgical treatment, and low SES. CONCLUSIONS: The authors determined that adult age, Hispanic race, metastatic disease, large tumor size, and low SES are poor prognostic factors for overall survival among Ewing sarcoma patient cases. Cancer 2010;116:1964-73. (C) 2010 American Cancer Society.