肿瘤科
癌症
比例危险模型
存活率
生存分析
阶段(地层学)
总体生存率
危险系数
化疗
回顾性队列研究
作者
Jin Seo Lee,Ji Yong Ahn,Kee Don Choi,Ho June Song,Yong-Hee Kim,Gin Hyug Lee,Hwoon-Yong Jung,Jin-Sook Ryu,Sung-Bae Kim,Jong Hoon Kim,Seung-Il Park,Kyung Ja Cho,Jin-Ho Kim
出处
期刊:The Korean Journal of Internal Medicine
日期:2016-02-11
卷期号:31 (2): 253-259
被引量:19
标识
DOI:10.3904/kjim.2014.182
摘要
BACKGROUND/AIMS Unexpected diagnosis of synchronous second primary cancers (SPC) complicates physicians' decision-making because clinical details of squamous esophageal cancer (EC) patients with SPC have been limited. We evaluated clinical features and treatment outcomes of patients with synchronous SPC detected during the initial staging of squamous EC. METHODS We identified a total of 317 consecutive patients diagnosed with squamous EC. Relevant clinical and cancer-specific information were reviewed retrospectively. RESULTS EC patients with synchronous SPC were identified in 21 patients (6.6%). There were significant differences in median age (70 years vs. 63 years, p = 0.01), serum albumin level (3.3 g/dL vs. 3.9 g/dL, p < 0.01) and body mass index (20.4 kg/m(2) vs. 22.8 kg/m(2), p = 0.01) between EC patients with and without SPC. Head and neck, lung and gastric cancers accounted for 18.2%, 22.7%, and 18.2% of SPC, respectively. Positron emission tomography-computed tomography (PET-CT) detected four cases (18.2%) of SPC that were missed on CT. Management plans were altered in 13 of 21 patients (61.9%) with detected SPC. Curative esophagectomy was attempted in 28.6% of EC patients with SPC (vs. 59.1% of patients without SPC; p = 0.006). EC patients with SPC had significantly lower 5-year survival than patients without SPC (10.6% vs. 36.7%, p = 0.008). CONCLUSIONS Synchronous SPC were found in 6.6% of squamous EC patients, and PET-CT contributed substantially to the detection of synchronous SPC. EC patients with SPC had poor survival due to challenges of providing stage-appropriate treatment.
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