Predictors of survival among older adults with ependymoma
Predictors of survival among older adults with ependymoma
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DOI：
10.1007/s11060-011-0730-2
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发表时间：
2012-03-01
影响因子：
3.9
通讯作者：
Scheurer, Michael E.
中科院分区：
文献类型：
--
作者：
Amirian, E. Susan;Armstrong, Terri S.;Scheurer, Michael E.
衰老的生物学过程包括许多复杂的生理和生活方式的变化，这些变化可能会改变影响老年室管膜瘤患者生存的典型预后因素。由于对传统预后因素的临床意义及其在老年人中的影响程度知之甚少，因此本研究的目的是评估60岁及以上室管膜瘤患者的生存率与人口统计学和肿瘤特征之间的关系。使用监测、流行病学和最终结果（SEER）项目1973-2007年的数据集，我们利用多变量Cox比例风险回归，评估了几个因素对总生存率和室管膜瘤特异性生存率的影响。我们确定了367例室管膜瘤患者，他们在诊断时年龄在60岁或以上，并有完整的SEER数据。其中19例（5.2%）为间变性肿瘤；其余均为低级别肿瘤。年龄、肿瘤部位、手术范围和肿瘤组织学是室管膜瘤预后的重要预测因素。预后不良的最强预测因子是幕上肿瘤的位置（与脊髓肿瘤相比，调整后HR: 6.94, 95% CI: 3.19-15.08）。我们的研究表明，肿瘤位置、肿瘤组织学和手术切缘可能是老年室管膜瘤患者生存的关键预测因素。我们相信我们的研究是第一个评估这些因素对老年患者室管膜瘤生存的预后价值的研究之一。
The biological process of aging encompasses a multitude of complex physiological and lifestyle changes that may alter the way typical prognostic factors affect survival among older ependymoma patients. Because very little is known about the clinical significance of traditional prognostic factors and the magnitude of their effects among older individuals, the purpose of this study was to evaluate the associations between survival and demographic and tumor characteristics among patients with ependymoma who were 60 years of age or older. Using the 1973-2007 dataset from the Surveillance, Epidemiology and End Results (SEER) program, we evaluated the impact of several factors on both overall and ependymoma-specific survival, utilizing multivariable Cox proportional hazards regression. We identified 367 ependymoma cases who were 60 years of age or older at diagnosis and had complete data from SEER. Of these, 19 (5.2%) had anaplastic tumors; all others were low-grade tumors. Age, tumor site, extent of surgery, and tumor histology were found to be significant predictors of ependymoma prognosis. The strongest predictor of poor outcome was supratentorial tumor location (adjusted HR: 6.94, 95% CI: 3.19-15.08, compared to spinal cord tumors). Our study suggests that tumor location, tumor histology, and surgical margin may be key predictors of survival among older ependymoma patients. We believe our study is one of the first to assess the prognostic value of these factors for ependymoma survival exclusively in an older patient population.