肿瘤大小对阴茎鳞状细胞癌患者生存预后的影响  

Effect of primary tumor size on survival of patients with squamous cell carcinoma of the penis

作　　者：李明林[1] 任中海[2] 马慧利[2] 梅馨月 胡跃世[1] 杨立新[1] LI Minglin;REN Zhonghai;MA Huili;MEI Xinyue;HU Yueshi;YANG Lixin(Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院泌尿外科,南阳473000 [2]南阳市中心医院肿瘤内科,南阳473000

出　　处：《现代泌尿生殖肿瘤杂志》2023年第6期341-345,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨肿瘤大小对阴茎鳞状细胞癌(SCCP)患者生存预后的影响。方法提取2004至2019年监测、流行病学和最终结果(SEER)数据库中诊断为SCCP的患者。使用X-tile软件确定肿瘤大小的最佳截断值,将研究对象分为≤3 cm组和>3 cm组。使用Kaplan-Meier法绘制两组患者的生存曲线并使用Log-rank检验比较组间差异。多重插补法填补基线缺失数据后,使用Cox比例风险模型分析肿瘤大小对SCCP患者肿瘤特异性生存期(CSS)和总生存期(OS)的影响。按肿瘤分期(局限性、区域性、远处转移)、分化程度(高分化、中分化、低分化或未分化)进行亚组分析。结果共计3468例患者纳入研究,平均年龄(66.47±14.13)岁,其中≤3 cm组1888例,>3 cm组1580例。Log-rank检验结果显示,两组患者CSS(χ2=125.29,P<0.001)与OS(χ2=82.95,P<0.001)的差异均有统计学意义。Cox回归分析显示,肿瘤较大(>3 cm)是影响SCCP患者CSS(HR=1.59,95%CI:1.35~1.86,P<0.001)和OS(HR=1.31,95%CI:1.18~1.45,P<0.001)的独立危险因素。亚组分析显示,肿瘤大小与SCCP患者CSS和OS之间的关系稳定,不受肿瘤分期、分化程度分层因素的影响(P交互>0.05)。结论肿瘤大小是SCCP患者重要的预后因素,肿瘤较大(>3 cm)是影响SCCP患者生存预后的独立危险因素。Objective To explore the value of primary tumor size in predicting the prognosis of patients with squamous cell carcinoma of the penis(SCCP).Methods We extracted the data of patients diagnosed as SCCP from 2004 to 2019 from Surveillance,Epidemiology and End Results(SEER)database.The X-tile software was used to define the best cut-off value,then the patients were divided into≤3 cm and>3 cm groups by it.The Kaplan-Meier method was used to plot the survival curves of both groups and the Log-rank test was conducted in parallel.After filling in the missing baseline data by multiple imputation method,univariate and multivariate cox regression analysis were used to assess the impact of primary tumor size on cancer-specific survival(CSS)and overall survival(OS)of patients with SCCP.Patients were divided into different subgroups based on tumor staging(localized,regional,and distant metastasis)and differentiation degree(well differentiated,moderately differentiated,poorly differentiated or undifferentiated),then the impact of primary tumor size on CSS and OS of SCCP patients in different subgroups were assessed.Results A total of 3468 patients were included in the study.The mean age of the patients was(66.47±14.13)years,including 1888 cases in the≤3 cm group and 1580 cases in the>3 cm group.Log-rank test showed that the difference between the two groups was statistically significant in both CSS(χ2=125.29,P<0.001)and OS(χ2=82.95,P<0.001).Cox regression analysis showed that large primary tumor size(>3 cm)was an independent risk factor for CSS(HR=1.59,95%CI 1.35-1.86,P<0.001)and OS(HR=1.31,95%CI 1.18-1.45,P<0.001)of patients with SCCP.Subgroup analysis indicated that the relationship between tumor size and CSS,OS in SCCP patients was stable,but not influenced by factors such as tumor staging or differentiation level(P for interaction>0.05).Conclusions Tumor size is an important prognostic factor for SCCP patients,and larger tumor size(>3 cm)is an independent risk factor for survival prognosis in patients with SCCP.

关 键 词：阴茎肿瘤 预后 生存分析 危险因素 

分 类 号：R737.27[医药卫生—肿瘤]