手术治疗对直肠小细胞神经内分泌癌患者预后影响的SEER数据库分析  

Effect of surgical treatment on prognosis in patients with rectal small cell neuroendocrine carcinoma based on SEER database

作　　者：黄坤 何运胜 赵攀[1] 赵平武[1] HUANG Kun;HE Yunsheng;ZHAO Pan;ZHAO Pingwu(Department of General Surgery,Mianyang Traditional Chinese Medicine Hospital,Mianyang,Sichuan 621000,P.R.China)

机构地区：[1]绵阳市中医医院普外科,四川绵阳621000

出　　处：《中国普外基础与临床杂志》2023年第2期179-184,共6页Chinese Journal of Bases and Clinics In General Surgery

基　　金：绵阳市应用技术研究与开发项目(项目编号:2019YFZJ004)。

摘　　要：目的探讨手术治疗在直肠小细胞神经内分泌癌(rectal small cell neuroendocrine carcinoma,RSCC)中的价值。方法提取SEER数据库中2000–2019年期间经病理确诊的RSCC患者的临床资料,探索手术对肿瘤特异生存期(cancer-specific survival,CSS)和总生存期(overall survival,OS)的影响。结果348例RSCC患者的中位随访时间为8个月(IQR:3~16个月)。手术组101例患者中,死亡84例(83.2%),其中肿瘤相关性死亡56例(55.4%);非手术组247例患者中,死亡215例(87.0%),其中肿瘤相关性死亡131例(53.0%)。估算的手术组与非手术组的1年OS分别为:49.6%和34.4%,1年CSS分别为:62.2%和49.2%。手术组和非手术组患者的OS和CSS曲线比较差异有统计学意义(均P<0.05)。多因素Cox比例风险回归结果显示:分化程度、SEER分期、手术、化疗和放疗是OS的影响因素(均P<0.05);SEER分期、手术、化疗和放疗是CSS的影响因素(均P<0.05)。接受手术治疗患者的OS[RR=0.61,95%CI为(0.45,0.81),P<0.001]和CSS[RR=0.67,95%CI为(0.47,0.95),P=0.025]较好。结论手术治疗能改善RSCC患者的OS和CSS。Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma(RSCC).Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance,Epidemiology and End Results(SEER)database,to explore the effect of surgical treatment on cancer-specific survival(CSS)and overall survival(OS).Results A total of 348 cases were included with the median follow-up of 8 months(IQR:3–16 months).Of the 101 patients in the operation group,84 died(83.2%),including 56 tumor-related deaths(55.4%).Of the 247 patients in the non-operation group,215 died(87.0%),including 131 tumorrelated deaths(53.0%).The estimated 1-year OS of the operation group and the non-operation group were 49.6%and 34.4%,respectively,and the estimated 1-year CSS of those were 62.2%and 49.2%,respectively.There were significant differences between the two groups(both P<0.05).Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation,SEER stage,receiving operative treatment or not,receiving chemotherapy or not,and receiving radiotherapy or not were independent influencing factors for OS,and SEER stage,receiving operative treatment or not,receiving chemotherapy or not,and receiving radiotherapy or not were independent influencing factors for CSS(all P<0.05).The OS[RR=0.61,95%CI was(0.45,0.81),P<0.001]and CSS[RR=0.67,95%CI was(0.47,0.95),P=0.025]in RSCC patients were significantly improved by surgical treatment.Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.

关 键 词：直肠小细胞神经内分泌癌 手术治疗 预后 SEER数据库 

分 类 号：R735.37[医药卫生—肿瘤]