Differences in the prognostic value of tumor size on hepatocellular cancer-specific survival stratified by gender in a SEER population-based study
Differences in the prognostic value of tumor size on hepatocellular cancer-specific survival stratified by gender in a SEER population-based study
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在基于 SEER 人群的研究中，按性别分层的肿瘤大小对肝细胞癌特异性生存的预后价值的差异
DOI：
10.1177/2050640619845602
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发表时间：
2019-08-01
影响因子：
6
通讯作者：
Sun, Beicheng
中科院分区：
文献类型：
--
作者：
Zhang, Wenjie;Jin, Kangpeng;Sun, Beicheng
背景与目的肿瘤大小是影响肿瘤预后的重要因素。本研究旨在探讨性别和肿瘤大小之间的相互作用，以评估肝细胞癌（HCC）的癌症特异性生存率（CSS）。在这项研究中，我们检索了基于人群的监测、流行病学和最终结果（SEER）数据，并确定了1988年至2012年期间诊断为HCC的38，368例患者。将1998年至2007年诊断的患者分配到训练集（n = 19279），其余患者分配为SEER验证集（n = 19089）。通过“X-Tile”程序确定按性别分层的肿瘤大小的临界值的定义。采用Kaplan-Meier法和多因素考克斯回归模型分析长期生存结局和危险因素。结果不同肿瘤大小亚组间的5年CSS差异有统计学意义（p < 0.001）。当在男性中应用38 mm和75 mm肿瘤大小的截止点，以及在女性中应用38 mm和55 mm肿瘤大小的截止点时，分别通过X-Tile程序观察到最显著的差异（p < 0.001）。在训练集中，女性的五年CSS为27.5%，男性为25.7%，在验证集中，女性为33.9%，男性为31.1%（p < 0.001）。进一步的分析表明，这种显着差异存在于本地，区域和远程阶段的患者。结论这些结果表明，女性肝癌患者的生存率似乎高于男性。应强调性别相关的差异，特别是对于39至75 mm肿瘤的HCC患者。
Background and objective Tumor size is an important prognostic factor in cancers. This study aims at investigating the interaction between gender status and tumor size to evaluate cancer-specific survival (CSS) in hepatocellular carcinoma (HCC). Methods In this study, we searched Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 38,368 patients diagnosed with HCC between 1988 and 2012. Patients diagnosed between 1998 and 2007 were distributed into a training set (n = 19279), and the rest were assigned as a SEER validation set (n = 19089). Definition of cut-off value of tumor size stratified by gender was determined by the “X-Tile” program. The five-year CSS data were found. Long-term survival outcomes and risk factors were analyzed by the Kaplan–Meier methods and the multivariable Cox regression models. Results There were significant differences among these different tumor size subgroups with regards to five-year CSS (p < 0.001). When applying cutoff points of 38 mm and 75 mm tumor size in men, and 38 mm and 55 mm in women, the most significant difference was observed by the X-Tile program, respectively (p < 0.001). The five-year CSS was 27.5% for women and 25.7% for men in the training set, and 33.9% for women and 31.1% for men in the validating set (p < 0.001). Further analysis showed that this significant difference existed in localized, regional, and distant-stage patients. Conclusions These results demonstrated that women with HCC appeared to exhibit better survival rates than men. The sex-related discrepancies should be emphasized, particularly for HCC patients with 39 to 75 mm tumors.