基于风险分层的儿童肾母细胞瘤生存分析

Andy, Y. Sigumonrong
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摘要

目的:探讨棉兰亚当马利克医院WT患者预后因素。材料与方法:棉兰Adam Malik医院。通过单因素和多因素Cox回归分析来确定WT的独立预后因素。本研究的主要终点是通过对显著变量进行Kaplan-Meier分析获得的患者总生存期(OS)。结果:单因素Cox回归分析发现,性别是唯一的显著因素(HR = 0.218, p = 0.005),男性的危险比更高。多因素Cox回归分析得出诊断年龄(HR = 13.860, p = 0.014)和肿瘤切除不完全(HR = 0.056, p = 0.008)。对前面提到的三个显著变量进行Kaplan-Meier分析。只有性别产生显著的Mantel-Cox log-rank评分(p = 0.002),男性患者被发现具有更好的生存能力(中位生存期为476天,而女性为11天)。男孩的存活率为45.45%,而所有女孩都没有存活到截止日期。结论:儿童性别、诊断年龄、肿瘤切除状态等3个预后因素被证实是影响WT儿童总生存的预后因素。建议进一步研究涵盖更广泛的人口统计学领域,以确认有意义的结果。
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SURVIVAL ANALYSIS OF PEDIATRIC WILMS TUMOR BASED ON RISK STRATIFICATION
Objective: This study aims to determine prognostic factors of WT patient in Adam Malik Hospital, Medan. Material & Methods: at Adam Malik Hospital, Medan. Univariate and multivariate Cox regression analyses were performed to determine independent prognostic factors for WT. The primary endpoint of this study were patients’ overall survival (OS) obtained by performing Kaplan-Meier analysis on significant variables. Results: From the univariate Cox regression analysis, gender was found to be the sole significant factor (HR = 0.218, p = 0.005) with males have a higher hazard ratio. The multivariate Cox regression analysis yielded age of diagnosis (HR = 13.860, p = 0.014) and incomplete tumor removals (HR = 0.056, p = 0.008). Kaplan-Meier analysis were performed on three significant variables mentioned before. Only gender yielded a significant Mantel-Cox log-rank score (p = 0.002) with male patients were found to have better survivability (which median survival 476 days compared to females’ 11 days). The survival of the boys was 45.45% while all of the girls did not survive until the cut-off. Conclusion: Three prognostic factors, including children’s gender, age of diagnosis, and tumor removal status, were confirmed to be prognostic factors for the overall survival of children with WT. Further studies covering broader demographic areas were suggested to confirm significant results.  
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