中国癌症杂志2024,Vol.34Issue(4) :361-367.DOI:10.19401/j.cnki.1007-3639.2024.04.003

572例宫颈癌远处转移患者的转移特征及生存分析:以医院为基础的真实世界研究

Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer:a hospital-based real world study

沈洁 冯小双 温灏 周昌明 莫淼 王泽洲 袁晶 吴小华 郑莹
中国癌症杂志2024,Vol.34Issue(4) :361-367.DOI:10.19401/j.cnki.1007-3639.2024.04.003

572例宫颈癌远处转移患者的转移特征及生存分析:以医院为基础的真实世界研究

Metastasis patterns and survival analysis of 572 patients with metastatic cervical cancer:a hospital-based real world study

沈洁 1冯小双 1温灏 2周昌明 1莫淼 1王泽洲 1袁晶 1吴小华 2郑莹1
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作者信息

  • 1. 复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海 200032
  • 2. 复旦大学附属肿瘤医院肿瘤妇科,复旦大学上海医学院肿瘤学系,上海 200032
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摘要

背景与目的:让宫颈癌患者获得有效的治疗是全球消除宫颈癌的策略之一.本文通过分析以医院登记为基础的宫颈癌发生远处转移患者的转移特征及转移后生存情况,为改善宫颈癌患者的生存情况并最终消除宫颈癌提供真实世界的科学证据.方法:基于复旦大学附属肿瘤医院2008-2017年确诊并接受治疗的宫颈癌患者,纳入初诊时已发生远处转移或者随访过程中发生远处转移的宫颈癌患者共572例,通过患者复诊病史资料、电话随访及死因数据链接等方式收集生存信息.研究起始时间为转移发生时间,随访统计时间截至2020年11月1日.应用Kaplan-Meier法绘制总体及不同转移部位的生存曲线,并估计不同转移部位的中位生存时间及1、3和5年总生存(overall survival,OS)率.结果:随访中位时间为38.93个月,期间共发生全死因死亡348例.72.55%为单一部位转移,27.45%为多发性转移.在所有转移部位中,肺转移比例最高(41.26%),其次为骨转移(15.21%),肝转移占11.54%,位列第3位.发生转移后,1、3和5年的OS率分别为62.29%(95%CI:62.25~62.33)、33.13%(95%CI:33.08~33.18)和23.42%(95%CI:23.37~23.47).单一部位转移中,转移至肺后的1年OS率最高(72.52%),3和5年各个部位转移后的OS差异不显著.结论:宫颈癌最易发生远处转移的部位依次为肺、骨和肝,远处转移发生后患者的生存情况较差,规范和完善远处转移后的诊疗体系,可望改善患者的生存情况.

Abstract

Background and purpose:Effective treatment for cervical cancer patients is one of the global strategies to eliminate cervical cancer.By analyzing the metastasis characteristics and survival status of patients with distant metastasis of cervical cancer from a hospital-based cancer registry data,our study provided real-world evidence for better survival of cervical cancer and finally eliminating cervical cancer.Methods:A total of 572 cervical cancer patients who had metastasis cancer at the initial diagnosis or developed distant metastasis during follow-up in Fudan University Shanghai Cancer Center from 2008 to 2017 were included in this study.Medical records review,telephone visits and death registry data linkage were applied in collecting endpoint data.The first follow-up date was the diagnose date of metastasis,and the last follow-up date was November 1,2020.Kaplan-Meier method was applied in evaluating the 1-,3-and 5-year overall survival(OS)rates for overall and site-specific patients.Results:The median follow-up time was 38.93 months,and 348 cases died during the follow-up.72.55%were single site metastasis,and 27.45%were multiple metastases.Among all metastatic sites,the proportion of lung metastasis was the highest,41.26%,15.21%to bone,and 11.54%to liver.After metastasis,the 1-year,3-year and 5-year OS rates were 62.29%(95%CI:62.25-62.33),33.13%(95%CI:33.08-33.18)and 23.42%(95%CI:23.37-23.47),respectively.In single site metastasis,1-year OS was the highest after metastasis to the lung(72.52%).Besides,there was no significant difference among different metastatic sites,both in 3-year and 5-year OS.Conclusion:The most frequent distant metastatic sites of cervical cancer are lung,bone and liver.The survival rate after metastasis is poor.Further research with systematic treatment strategy is required for better survival.

关键词

宫颈癌/转移/生存率/医院登记

Key words

Cervical Cancer/Metastasis/Survival rate/Hospital-based registry

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基金项目

上海市加强公共卫生体系建设三年行动计划(2023-2025)(GWVI-11.2-YQ37)

上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22022308)

出版年

2024
中国癌症杂志
复旦大学附属肿瘤医院

中国癌症杂志

CSTPCDCSCD北大核心
影响因子:2.015
ISSN:1007-3639
参考文献量21
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