食管癌脑转移预后因素分析
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摘要
目的探讨食管癌脑转移的临床病理特点,研究食管癌脑转移的患者预后因素。方法使用8.3.5版SEER Stat软件提取美国监测、流行病学和最终结果 (SEER)数据库中2010—2015年39例食管癌脑转移患者的信息。X-tile软件用于确定年龄的最佳截止值。通过SPSS(v25.0)用Log-rank方法和Cox比例风险模型分析预后因素。结果食管癌脑转移患者中位生存时间为7.0个月,6个月生存率53.3%,1年生存率为16.3%。仅年龄(χ~2=4.045,P=0.044)为食管癌脑转移患者预后的影响因素,而尚无足够证据表明性别、婚姻、人种、原发灶部位、组织学分级、手术、病理类型、T分期和N分期与患者的预后有关。结论脑转移是食管癌的少见转移方式,年龄小与更差的预后相关,而其他的危险因素尚不明确。积极治疗会改善患者的预后。
Objective To investigate the prognostic factors of esophageal cancer with brain metastasis. Methods SEER Stat 8.3.5 was used to collect 39 cases of esophageal cancer with brain metastasis from 2010 to 2015 in the Surveillance, Epidemiology and End Results(SEER) database. X-tile software was used to determine the best cut-off value of the age. Prognostic factors were analyzed with log-rank and Cox proportional hazard model by SPSS(v25.0). Results The median survival time of patients with esophageal cancer with brain metastasis was 7.0 months, the 6-month survival rate was 53.3%, and the 1-year survival rate was 16.3%. Only age(χ~2=4.045, P=0.044)was the prognostic factor, while there was insufficient evidence to show whether gender, marriage, race, primary site, histological grade,surgery, pathological type, T stage or N stage was associated with the prognosis of the patients. Conclusion Brain metastasis is a rare metastatic type of esophageal cancer. Age is associated with worse prognosis, while the influences of other risk factors are not clear.Active treatment can lead to better prognosis.
Objective To investigate the prognostic factors of esophageal cancer with brain metastasis. Methods SEER Stat 8.3.5 was used to collect 39 cases of esophageal cancer with brain metastasis from 2010 to 2015 in the Surveillance, Epidemiology and End Results(SEER) database. X-tile software was used to determine the best cut-off value of the age. Prognostic factors were analyzed with log-rank and Cox proportional hazard model by SPSS(v25.0). Results The median survival time of patients with esophageal cancer with brain metastasis was 7.0 months, the 6-month survival rate was 53.3%, and the 1-year survival rate was 16.3%. Only age(χ~2=4.045, P=0.044)was the prognostic factor, while there was insufficient evidence to show whether gender, marriage, race, primary site, histological grade,surgery, pathological type, T stage or N stage was associated with the prognosis of the patients. Conclusion Brain metastasis is a rare metastatic type of esophageal cancer. Age is associated with worse prognosis, while the influences of other risk factors are not clear.Active treatment can lead to better prognosis.
引文
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[12]Ai D,Zhu H,Ren W,et al.Patterns of distant organ metastases in esophageal cancer:a population-based study[J].J Thorac Dis,2017,9(9):3023-3030.
[13]Kothari N,Mellon E,Hoffe SE,et al.Outcomes in patients with brain metastasis from esophageal carcinoma[J].J Gastrointest Oncol,2016,7(4):562-569.
[14]Depypere LP,Moons J,Lerut TE,et al.Palliative esophagectomy in unexpected metastatic disease:sense or nonsense?[J].Asian Cardiovasc Thorac Ann,2018,26(7):552-557.
[15]Kanazawa Y,Fujita I,Kakinuma D,et al.Five-year survival after surgical removal and gamma knife stereotactic radiosurgery for a cerebellar metastasis from an esophagogastric junction cancer:a case report and literature review[J].In Vivo,2017,31(6):1209-1214.
[16]Welch G,Ross H J,Patel N P,et al.Incidence of brain metastasis from esophageal cancer[J].Dis Esophagus,2017,30(9):1-6.
[17]Feng W,Zhang P,Zheng X,et al.Incidence and treatment of brain metastasis in patients with esophageal carcinoma[J].World JGastroenterol,2015,21(19):5805-5812.
[18]Liu M,Wang C,Gao L,et al.A nomogram to predict long-time survival for patients with M1 diseases of esophageal cancer[J].J Cancer,2018,9(21):3986-3990.
[2]Tanaka T,Fujita H,Matono S,et al.Outcomes of multimodality therapy for stage IVB esophageal cancer with distant organ metastasis(M1-Org)[J].Dis Esophagus,2010,23(8):646-651.
[3]王荣荣,陈淑兰,罗健.食管癌脑转移的研究进展[J].中国医师杂志,2016,18(1):14-17.
[4]National Cancer Institute.Surveillance,epidemiology,and end results program[EB/OL].[2019-04-08].http://seer.cancer.gov/registries/.
[5]鲍启德,张长江,刘敏,等.食管癌临床症状类型及其年龄和性别分布特征[J].新乡医学院学报,2017,34(07):570-573.
[6]Barz H,Barz D.Age dependence of metastases.A study of more than 5000 cases of death from cancer[J].Arch Geschwulstforsch,1984,54(1):77-83.
[7]Feng W,Zhang P,Zheng X,et al.Neuroimaging and clinical characteristics of brain metastases from esophageal carcinoma in Chinese patients[J].J Cancer Res Ther,2014,10 Suppl:296-303.
[8]Wu SG,Zhang WW,Sun JY,et al.Patterns of distant metastasis between histological types in esophageal cancer[J].Front Oncol,2018,8:302.
[9]Rice TW,Rusch VW,Apperson-Hansen C,et al.Worldwide esophageal cancer collaboration[J].Dis Esophagus,2009,22(1):1-8.
[10]Ai D,Zhu H,Ren W,et al.Patterns of distant organ metastases in esophageal cancer:a population-based study[J].J Thorac Dis,2017,9(9):3023-3030.
[11]Chaichana KL,Gadkaree S,Rao K,et al.Patients undergoing surgery of intracranial metastases have different outcomes based on their primary pathology[J].Neurol Res,2013,35(10):1059-1069.
[12]Ai D,Zhu H,Ren W,et al.Patterns of distant organ metastases in esophageal cancer:a population-based study[J].J Thorac Dis,2017,9(9):3023-3030.
[13]Kothari N,Mellon E,Hoffe SE,et al.Outcomes in patients with brain metastasis from esophageal carcinoma[J].J Gastrointest Oncol,2016,7(4):562-569.
[14]Depypere LP,Moons J,Lerut TE,et al.Palliative esophagectomy in unexpected metastatic disease:sense or nonsense?[J].Asian Cardiovasc Thorac Ann,2018,26(7):552-557.
[15]Kanazawa Y,Fujita I,Kakinuma D,et al.Five-year survival after surgical removal and gamma knife stereotactic radiosurgery for a cerebellar metastasis from an esophagogastric junction cancer:a case report and literature review[J].In Vivo,2017,31(6):1209-1214.
[16]Welch G,Ross H J,Patel N P,et al.Incidence of brain metastasis from esophageal cancer[J].Dis Esophagus,2017,30(9):1-6.
[17]Feng W,Zhang P,Zheng X,et al.Incidence and treatment of brain metastasis in patients with esophageal carcinoma[J].World JGastroenterol,2015,21(19):5805-5812.
[18]Liu M,Wang C,Gao L,et al.A nomogram to predict long-time survival for patients with M1 diseases of esophageal cancer[J].J Cancer,2018,9(21):3986-3990.