背景:恶性胸膜间皮瘤(MPM)是胸膜腔内细胞的侵袭性癌,总体发病率较低。国家癌症数据库(NCDB)于2022年8月发布了最新数据,反映了MPM的最新趋势。
方法:对NCDB在2004年至2020年间诊断为MPM的患者进行了查询。收集的变量包括人口统计,肿瘤特征,和治疗。采用学生t检验和独立样品比例检验进行均值分析。使用SPSS版本28通过Kaplan-Meier方法评估生存率。
结果:共有41,074例患者被诊断为间皮瘤,在2004年至2017年期间,发病率稳定(0.25%)。诊断的平均年龄为70岁(SD13)。73.2%的患者为男性,69%没有合并症,93.3%为白色。更多的患者在2008年后被诊断为1期(p<0.001)。自2010年以来,接受治疗的患者显着增加,73.9%接受某种治疗(p<0.01):50.5%接受化疗,27.6%手术,8.6%的辐射,和5.4%的免疫治疗。诊断后中位总生存期为10.3个月[95%CI:10.2-10.5]。与手术干预30天死亡率相关的危险因素包括年龄(OR=1.02,p<0.001),男性(OR=1.3,p=0.03),低分化等级(OR=2.1,p<0.001),阶段4(OR=1.4,p=0014),和上皮样组织学(OR=0.51,p=0.03)。
结论:目前MPM的管理基于分期和组织学亚型。由于大多数学术中心的患者人数很少,NCDB提供了一个稳健的数据集,在与患者的治疗讨论中利用广泛的数据点.
Malignant pleural mesothelioma (MPM) is an aggressive cancer of the cells lining the pleural cavity with a low overall incidence. The National Cancer Database (NCDB) released in August 2022 updated data that reflect the newest trends in MPM.
The NCDB was queried for patients diagnosed with MPM between 2004 and 2020. Variables collected included demographics, tumor characteristics, and treatment. Student\'s t-test and independent-samples proportions test were used for means analysis. Survival was assessed by the Kaplan-Meier method using SPSS version 28.
A total of 41,074 patients were diagnosed with mesothelioma, with a steady incidence (0.25%) between 2004 and 2017. The mean age of diagnosis was 70 (SD 13). 73.2% of the patients were males, 69% had no comorbidities, and 93.3% were white. More patients were diagnosed at Stage 1 after 2008 (p < 0.001). Since 2010, there has been a significant increase in patients offered treatment with 73.9% receiving some therapy (p < 0.01): 50.5% received chemotherapy, 27.6% surgery, 8.6% radiation, and 5.4% immunotherapy. The median overall survival was 10.3 months from diagnosis [95% CI: 10.2-10.5]. Risk factors associated with 30-day mortality from surgical intervention included age (OR = 1.02, p < 0.001), male gender (OR = 1.3, p = 0.03), poorly differentiated grade (OR = 2.1, p < 0.001), Stage 4 (OR = 1.4, p = 0014), and epithelioid histology (OR = 0.51, p = 0.03).
The current management of MPM is based on stage and histologic subtype. Due to the small numbers of patients at most academic centers, the NCDB provides a robust dataset to draw upon broad data points in treatment discussions with patients.