肝内胆管癌患者手术治疗与术后联合放疗的疗效对比:基于SEER数据库的倾向评分匹配研究  

Comparison of efficacy between surgical treatment and postoperative adjuvant for intrahepatic cholangiocinoma patients:A propensity score matching study based on the SEER database

作　　者：潘晓涛 南虹 曹秋祥 PAN Xiaotao;NAN Hong;CAO Qiuxiang(Department of General Surgery,Shaanxi Provincial Cancer Hospital,Shaanxi Xi'an 710061,China;Department of Surgery,521 Hospital of Ordnance Industry,Shaanxi Xi'an 710061,China;Department of Surgery,Caijiapo Hospital of Baoji City,Shaanxi Baoji 722405,China)

机构地区：[1]陕西省肿瘤医院普外科,陕西西安710061 [2]兵器工业五二一医院外科,陕西西安710061 [3]宝鸡市蔡家坡医院外科,陕西宝鸡722405

出　　处：《现代肿瘤医学》2022年第3期495-499,共5页Journal of Modern Oncology

摘　　要：目的:本研究旨在比较肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)患者手术治疗与手术后联合放疗的生存期,探讨手术后辅助放疗的可行性,为ICC的临床治疗提供依据。方法:提取美国TheSurveillance,Epidemiology,and End Results(SEER)数据库2004至2015年间诊断为ICC患者的临床资料,根据手术后是否放疗,将患者分为手术组(surgery)和手术后放疗组(radiation after surgery),采用Kaplan-Meier方法比较两组总体生存期(overall survival,OS)和肝癌特异性生存期(liver cancer specific survival,LCSS)的差异。在进行了1∶1倾向评分匹配(propensity score matching,PSM)之后,再次比较OS与LCSS的差异。然后进行亚组分析比较手术组与手术后放疗组的疗效。最后收集本院数据对数据库结果进行验证。结果:共有470例患者纳入研究,其中手术组患者410例,手术后放疗组患者60例。PSM前手术组与手术后放疗组的中位OS(19.00个月vs 26.00个月,P=0.268)和中位LCSS(19.00个月vs 26.00个月,P=0.591)无明显差异,PSM后手术组与手术后放疗组的中位OS(25.50个月vs 26.00个月,P=0.531)和中位LCSS(27.00个月vs 26.00个月,P=0.302)亦无明显差异。在亚组分析中,手术后放疗并不是ICC患者总体生存的保护因素。本院数据结果与数据库结果一致。结论:ICC患者手术后辅助放疗相较于手术治疗并不会延长患者生存。Objective:To compare the survival of patients with intrahepatic cholangiocarcinoma(ICC)after surgical treatment with postoperative radiotherapy,to explore the feasibility of postoperative adjuvant radiotherapy,and to provide a basis for the clinical treatment of ICC.Methods:The clinical data of patients diagnosed as ICC in The Surveillance,Epidemiology and End Results(SEER)database from 2004 to 2015 were extracted.Patients were divided into surgery group and post-operative radiotherapy group.Using Kaplan-Meier method to compare the overall survival(OS)and liver cancer specific survival(LCSS)difference between the two groups.After 1∶1 propensity score matching(PSM),the difference between OS and LCSS was compared again.Then a subgroup analysis was performed to compare the efficacy of the surgery group and the postoperative radiotherapy group.Finally,data from our hospital were collected to verify the database results.Results:A total of 470 patients were included in the study,including 410 patients in the surgery group and 60 patients in the postoperative radiotherapy group.There was no significant difference between the medium OS(19.00 months vs 26.00 months,P=0.268)and the medium LCSS(19.00 months vs 26.00 months,P=0.591)between the surgery group and the postoperative radiotherapy group before PSM.The medium OS(25.50 months vs 26.00 months,P=0.531)and the medium LCSS(27.00 months vs 26.00 months,P=0.302)were also not significantly different after PSM.In the subgroup analysis,postoperative radiotherapy was not a protective factor for the overall survival of ICC patients.The data results of our hospital were consistent with the database results.Conclusion:Compared with surgical treatment,adjuvant radiotherapy for ICC patients does not prolong survival.

关 键 词：肝内胆管癌 术后放疗 倾向评分匹配 总体生存 肝癌特异性生存 

分 类 号：R735.7[医药卫生—肿瘤]