論文No2351
Survival comparison of Three histological subtypes of lung squamous cell carcinoma: A population-based propensity score matching analysis
Na An, Xuejiao Leng, Xue Wang, Yile Sun, Zhiwei Chen
LUNG CANCER, April 2020, Volume 142, Pages 13–19.
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＜目的＞
この研究では、類基底扁平上皮癌(BSCC)、角化扁平上皮癌(KSCC)、非角化扁平上皮癌(NKSCC)の
生存の相違を解析し、類基底扁平上皮癌(BSCC)の予後因子を探索することである。
＜方法＞
2005年から2014年にかけてSEERデータベースから4743名の患者情報を検索した。
傾向スコアマッチング(PSM)を使用して交絡因子を補正した。
全生存期間(OS)、がん特異的生存(CSS)、累積のがん特異的死亡(CSM)を比較解析により評価した。
競合リスク回帰モデルを使用して肺BSCCの予後因子を同定した。
＜結果＞
PSM後、肺BSCCはKSCCやNKSCCよりもCSS率が高かった
(5-year CSS rate: 50.4 % vs. 37.7 % vs. 38.5 %, p = 0.033 and p = 0.033)。
CSMの累積頻度はBSCCの方がKSCCやNKSCCよりも低かった
(5-year CSM rate: 46.4 % vs. 56.9 % vs. 56.4 %, p = 0.046 and p = 0.042)。
この結果はPSM前でも同様であった。
KSCCとNKSCCでは、生存の差異はなかった (5-year CSS rate: 37.7 % vs. 38.5 %, p = 0.997)。
競合リスク回帰解析で、BSCCの予後因子として、T因子、N因子、M因子、手術が同定された。
＜感想＞
肺扁平上皮がんのうち、類基底扁平上皮癌(BSCC)は、角化扁平上皮癌(KSCC)、
非角化扁平上皮癌(NKSCC)よりも予後が良好だったようです。
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Objectives
This study is aimed to analyze the survival differences among patients with lung basaloid squamous cell carcinoma (BSCC), keratinizing squamous cell carcinoma (KSCC), and nonkeratinizing squamous cell carcinoma (NKSCC), and explore the prognostic factors of patients with lung BSCC.
Materials and Methods
We searched the information of 4743 patients with lung SCC between 2005 and 2014 from the SEER database. Propensity score matching (PSM) was used to adjust confounding factors. The overall survival (OS), cancer-specific survival (CSS), and cumulative incidence of cancer-specific mortality (CSM) were estimated with a comparative analysis. A competing risks regression model was conducted to identify the prognostic factors of lung BSCC.
Results
After PSM, patients with lung BSCC had a higher CSS rate than those with lung KSCC or NKSCC (5-year CSS rate: 50.4 % vs. 37.7 % vs. 38.5 %, p = 0.033 and p = 0.033). The cumulative incidence of CSM was lower for patients with lung BSCC than those with lung KSCC or NKSCC (5-year CSM rate: 46.4 % vs. 56.9 % vs. 56.4 %, p = 0.046 and p = 0.042), which were similar to the results before PSM. As for patients with lung KSCC and NKSCC, there was no survival differences between them (5-year CSS rate: 37.7 % vs. 38.5 %, p = 0.997). The competing risks regression analysis showed that T stage, N stage, M stage and surgery were independent prognostic factors for patients with lung BSCC (all p < 0.05).
Conclusions
Patients with lung BSCC had a better survival than those with lung KSCC or NKSCC, while no survival differences were found between lung KSCC and NKSCC. T stage, N stage, M stage and surgery were independent prognostic factors for patients with lung BSCC.