中国临床医学2024，Vol.31Issue(2)：192-199,8.DOI:10.12025/j.issn.1008-6358.2024.20231653
T1期结肠神经内分泌肿瘤患者转移及接受不同治疗策略后生存分析
Analysis of metastasis and survival after different treatment in patients with T1 stage colonic neuroendocrine tumors
摘要
Abstract
Objective To explore the metastasis rate and related risk factors of T1 stage colonic neuroendocrine tumor(C-NET),and to compare the long-term survival outcomes of patients with non-metastatic(T1N0M0 stage)C-NET after local excision(LE)or radical surgery(RS).Methods Clinical information of 433 patients diagnosed with C-NET in the SEER database from January 1,2004 to December 31,2015 were analyzed.Cox regression was used to analyze the influencing factors of metastasis of C-NET.The patients without metastasis were divided into LE group and RS group,and assigned in a 1∶1 ratio using propensity score matching(PSM)according to gender,age,tumor largest diameter,and infiltration depth,with a caliper value set to 0.02.Kaplan-Meier survival curve was used to analyze 5-year cancer-specific survival(CSS)and overall survival(OS)of patients.Cox regression analysis was used to evaluate the influence of metastasis on survival.Results Among 419 C-NET patients,19(4.52%)had distant metastases.Cox regression analysis showed that 11-20 mm of tumor large diameter(HR=9.264,95%CI 3.322-25.835,P＜0.001),right colon location(HR=0.116,95%CI 0.042-0.321,P＜0.001),and submucosal invasion(HR=5.842,95%CI 1.858-18.371,P=0.003)were independent risk factors for distant metastasis of T1 stage C-NET.The 5-year OS rates of non-metastatic and metastatic patients were 94.5%and 47.4%,respectively(χ2=79.762,P＜0.001),and their 5-year CSS rates were 99.5%and 55.7%,respectively(χ2=164.604,P＜0.001).Before PSM,the 5-year OS rates of non-metastatic C-NET patients after LE and RS were 95.8%and 90.1%(χ2=2.679,P=0.063),and the 5-year CSS rates were 100.0%and 97.2%(χ2=0.579,P=0.038);after PSM,the 5-year OS rates of non-metastatic patients after LE and RS were 96.8%and 92.1%(χ2=3.606,P=0.058),and the 5-year CSS rates were 100.0%and 98.5%(χ2=1.015,P=0.314).After PSM,there was no significant difference in the 5-year OS and CSS of patients with defferent tumor location,tumor large diameter,or submucosal invasion between the LE and RS groups.Conclusions 11-20 mm of tumor diameter,right colon location,and submucosal invasion might be independent risk factors for distant metastasis of T1 stage C-NET,and LE could be an appropriate treatment option for non-metastatic C-NET.关键词
神经内分泌肿瘤/结肠/治疗策略/转移/SEER数据库Key words
neuroendocrine tumor/colon/treatment strategie/metastasis/SEER database分类
医药卫生引用本文复制引用
白斌,李恒,汪军,肖华,蔡慧..T1期结肠神经内分泌肿瘤患者转移及接受不同治疗策略后生存分析[J].中国临床医学,2024,31(2):192-199,8.基金项目
上海市宝山区科学技术委员会科技创新专项资金(2023-E-19),上海市浦东新区卫生健康委员会面上项目(PW2021A-28),上海中医药大学附属第七人民医院"启明星"人才培养计划项目(QMX2021-01).Supported by Science and Technology Innovation Special Fund Project of Shanghai Baoshan District Science and Technology Committee(2023-E-19),General Project of Shanghai Pudong New Area Health Commission(PW2021A-28),and Talents Training Program of Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine(QMX2021-01). （2023-E-19）
