背景:本研究的目的是采用基于监视的竞争风险模型,流行病学,和最终结果(SEER)数据库,以确定老年乙状结肠腺癌(SCA)患者的预后因素,并将其与经典的Cox比例风险模型进行比较。
方法:我们从2010年至2015年SEER数据库中登记的诊断为SCA的老年患者中提取数据。使用累积发生率函数和Gray检验进行单变量分析,同时使用Fine-Gray和Cox比例风险模型进行多变量分析。
结果:在诊断为SCA的10,712名合格的老年患者中,5595人死亡:2987人死于乙状结肠腺癌,2608人死于其他原因。单向格雷测试的结果表明,年龄,种族,婚姻状况,AJCC阶段,分化等级,肿瘤大小,手术状态,肝转移状态,肺转移状态,脑转移状态,放疗状态,化疗状态均影响SCA的预后(P<0.05)。多因素分析显示,性别,年龄,种族,婚姻状况,手术状态影响SCA的预后(P<0.05)。多因素精细-灰色分析显示,影响SCA患者预后的关键因素包括年龄,种族,婚姻状况,AJCC阶段,等级分类,手术状态,肿瘤大小,肝转移,肺转移,和化疗状态(P<0.05)。
结论:来自SEER数据库的数据被用于使用竞争风险模型更准确地估计乙状结肠腺癌特异性死亡率和预后因素的CIFs。
BACKGROUND: The purpose of this study is to employ a competing risk model based on the Surveillance, Epidemiology, and End Results (SEER) database to identify prognostic factors for elderly individuals with sigmoid colon adenocarcinoma (SCA) and compare them with the classic Cox proportional hazards model.
METHODS: We extracted data from elderly patients diagnosed with SCA registered in the SEER database between 2010 and 2015. Univariate analysis was conducted using cumulative incidence functions and Gray\'s test, while multivariate analysis was performed using both the Fine-Gray and Cox proportional hazards models.
RESULTS: Among the 10,712 eligible elderly patients diagnosed with SCA, 5595 individuals passed away: 2987 due to sigmoid colon adenocarcinoma and 2608 from other causes. The results of one-way Gray\'s test showed that age, race, marital status, AJCC stage, differentiation grade, tumor size, surgical status, liver metastasis status, lung metastasis status, brain metastasis status, radiotherapy status, and chemotherapy status all affected the prognosis of SCA (P < .05). Multivariate analysis showed that sex, age, race, marital status, and surgical status affected the prognosis of SCA (P < .05). Multifactorial Fine-Gray analysis revealed that key factors influencing the prognosis of SCA patients include age, race, marital status, AJCC stage, grade classification, surgical status, tumor size, liver metastasis, lung metastasis, and chemotherapy status (P < .05).
CONCLUSIONS: Data from the SEER database were used to more accurately estimate CIFs for sigmoid colon adenocarcinoma-specific mortality and prognostic factors using competing risk models.