Background
Methods
Population selection
Statistical analysis
Results
Study participants
Patients’ clinical characteristics
Variable | All Patients (N = 384,996) | Tumor Histology | P value | ||
---|---|---|---|---|---|
AC (N = 349,891) | MAC (N = 30,965) | SRCC (N = 4140) | |||
Sex, No. (%) | < .001 | ||||
Male | 201,826 (52.4) | 184,408 (52.7) | 15,221 (49.2) | 2197 (53.1) | |
Female | 183,170 (47.6) | 165,483 (47.3) | 15,744 (50.8) | 1943 (46.9) | |
Age, y, No. (%) | < .001 | ||||
≤ 44 y | 19,932 (5.2) | 17,632 (5.0) | 1819 (5.9) | 481 (11.6) | |
45-59y | 91,886 (23.9) | 84,785 (24.2) | 6151 (19.9) | 950 (22.9) | |
60-74y | 141,249 (36.7) | 129,226 (36.9) | 10,646 (34.4) | 1377 (33.3) | |
≥ 75y | 131,929 (34.3) | 118,248 (33.8) | 12,349 (39.9) | 1332 (32.2) | |
Marital status, No. (%) | < .001 | ||||
Unmarried | 205,102 (53.3) | 186,964 (53.4) | 15,941 (51.5) | 2197 (53.1) | |
Married | 160,284 (41.6) | 144,728 (41.4) | 13,778 (44.5) | 1778 (42.9) | |
Unknown | 19,610 (5.1) | 18,199 (5.2) | 1246 (4.0) | 165 (4.0) | |
T, No. (%) | < .001 | ||||
T0 | 567 (0.1) | 499 (0.1) | 60 (0.2) | 8 (0.2) | |
Tis | 14,784 (3.8) | 14,650 (4.2) | 108 (0.3) | 26 (0.6) | |
T1 | 67,426 (17.5) | 65,451 (18.7) | 1692 (5.5) | 283 (6.8) | |
T2 | 50,455 (13.1) | 46,734 (13.4) | 3550 (11.5) | 171 (4.1) | |
T3 | 180,679 (46.9) | 161,305 (46.1) | 17,606 (56.9) | 1768 (42.7) | |
T4 | 52,617 (13.7) | 44,210 (12.6) | 6884 (22.2) | 1523 (36.8) | |
Tx | 18,468 (4.8) | 17,042 (4.9) | 1065 (3.4) | 361 (8.7) | |
N, No. (%) | < .001 | ||||
N0 | 230,313 (59.8) | 212,807 (60.8) | 16,251 (52.5) | 1255 (30.3) | |
N1 | 89,719 (23.3) | 80,920 (23.1) | 7874 (25.4) | 925 (22.3) | |
N2 | 53,294 (13.8) | 45,509 (13.0) | 6087 (19.7) | 1698 (41.0) | |
NX | 11,670 (3.0) | 10,655 (3.0) | 753 (2.4) | 262 (6.3) | |
M, No. (%) | < .001 | ||||
M0 | 310,099 (80.5) | 282,887 (80.9) | 24,669 (79.7) | 2543 (61.4) | |
M1 | 74,512 (19.4) | 66,626 (19.0) | 6291 (20.3) | 1595 (38.5) | |
MX | 385 (0.1) | 378 (0.1) | 5 (0.0) | 2 (0.0) | |
Stage, No. (%) | < .001 | ||||
0 | 14,784 (3.8) | 14,650 (4.2) | 108 (0.3) | 26 (0.6) | |
I | 95,327 (24.8) | 91,062 (26.0) | 4007 (12.9) | 258 (6.2) | |
II | 98,990 (25.7) | 87,722 (25.1) | 10,643 (34.4) | 625 (15.1) | |
III | 101,383 (26.3) | 89,831 (25.7) | 9916 (32.0) | 1636 (39.5) | |
IV | 74,512 (19.4) | 66,626 (19.0) | 6291 (20.3) | 1595 (38.5) | |
Grade, No. (%) | < .001 | ||||
I | 32,258 (8.4) | 29,373 (8.4) | 2861 (9.2) | 24 (0.6) | |
II | 244,735 (63.6) | 226,222 (64.7) | 18,318 (59.2) | 195 (4.7) | |
III | 58,637 (15.2) | 50,223 (14.4) | 5603 (18.1) | 2811 (67.9) | |
IV | 7371 (1.9) | 6053 (1.7) | 853 (2.8) | 465 (11.2) | |
Unknown | 41,995 (10.9) | 38,020 (10.9) | 3330 (10.8) | 645 (15.6) |
Prognostic factors
Covariate | 5-y Overall Survival | 5-y Cancer-Specific Survival | ||||
---|---|---|---|---|---|---|
Total No. (OS, %) | Logistic Analysis | Total No. (CSS, %) | Logistic Analysis | |||
Hazard Ratio (95% CI) | P Value | Hazard Ratio (95% CI) | P Value | |||
Sex | ||||||
Male | 161,545 (56.7) | 1 [Reference] | 160,455 (66.6) | 1 [Reference] | ||
Female | 146,618 (57.6) | 0.964 (0.950–0.978) | < .001 | 145,807 (67.2) | 0.973 (0.959–0.988) | < .001 |
Age, y | ||||||
≤ 44 y | 18,591 (65.2) | 1 [Reference] | 18,463 (67.1) | 1 [Reference] | ||
45-59y | 82,523 (67.1) | 0.919 (0.888–0.950) | < .001 | 82,076 (70.6) | 0.849 (0.821–0.879) | < .001 |
60-74y | 114,178 (61.8) | 1.158 (1.121–1.196) | < .001 | 113,505 (69.7) | 0.887 (0.858–0.917) | < .001 |
≥ 75y | 92,871 (41.5) | 2.641 (2.556–2.729) | < .001 | 92,218 (60.1) | 1.354 (1.310–1.400) | < .001 |
Marital status | ||||||
Married | 165,165 (62.8) | 1 [Reference] | 164,265 (70.8) | 1 [Reference] | ||
Unmarried | 127,587 (49.1) | 1.750 (1.724–1.776) | < .001 | 126,716 (61.1) | 1.544 (1.520–1.568) | < .001 |
Unknown | 15,411 (61.7) | 1.048 (1.013–1.084) | .007 | 15,281 (72.1) | 0.938 (0.904–0.974) | < .001 |
0 | 11,192 (80.0) | 1 [Reference] | 11,142 (93.6) | 1 [Reference] | ||
I | 72,764 (77.7) | 1.148 (1.093–1.206) | < .001 | 72,462 (91.4) | 1.376 (1.270–1.491) | < .001 |
II | 78,593 (68.3) | 1.857 (1.768–1.949) | < .001 | 78,201 (81.6) | 3.298 (3.050–3.565) | < .001 |
III | 83,499 (59.4) | 2.734 (2.605–2.869) | < .001 | 83,024 (67.9) | 6.914 (6.400–7.469) | < .001 |
IV | 62,115 (10.6) | 33.736 (31.998–35.568) | < .001 | 61,433 (12.1) | 106.242 (98.109–115.050) | < .001 |
Histology | ||||||
AC | 280,930 (58.0) | 1 [Reference] | 279,229 (67.8) | 1 [Reference] | ||
MAC | 24,018 (50.7) | 1.343 (1.308–1.379) | < .001 | 23,849 (60.9) | 1.352 (1.316–1.389) | < .001 |
SRCC | 3215 (26.8) | 3.772 (3.487–4.079) | < .001 | 3184 (32.5) | 4.373 (4.059–4.712) | < .001 |
Grade | ||||||
Grade I | 25,618 (69.4) | 1 [Reference] | 25,478 (81.1) | 1 [Reference] | ||
Grade II | 197,250 (60.7) | 1.468 (1.428–1.510) | < .001 | 196,101 (70.9) | 1.761 (1.704–1.820) | < .001 |
Grade III | 46,599 (44.4) | 2.840 (2.750–2.933) | < .001 | 46,277 (52.7) | 3.851 (3.714–3.994) | < .001 |
Grade IV | 5770 (44.7) | 2.806 (2.647–2.974) | < .001 | 5741 (53.3) | 3.760 (3.539–3.995) | < .001 |
Unknown | 32,926 (46.2) | 2.641 (2.552–2.733) | < .001 | 32,665 (54.6) | 3.568 (3.434–3.707) | < .001 |
Pathological subtypes and prognoses at every stage
Stage | Histology | Cox Regression | |||||
---|---|---|---|---|---|---|---|
AC Total No. (5-y OS, %) | MAC Total No. (5-y OS, %) | SRCC Total No. (5-y OS, %) | MAC vs. AC HR (95) CI% | P Value | SRCC vs. AC HR (95) CI% | P Value | |
0-IV | 280,930 (58.0) | 24,018 (50.7) | 3215 (26.8) | 1.238 (1.213–1.263) | < .001 | 1.592 (1.558–1.627) | < .001 |
0 | 11,113 (80.1) | 66 (69.1) | 13 (83.1) | 1.656 (1.054–2.602) | .029 | 0.954 (0.477–1.909) | .895 |
I | 69,751 (77.9) | 2848 (72.7) | 165 (63.4) | 1.268 (1.172–1.371) | < .001 | 1.387 (1.207–1.593) | < .001 |
II | 70,050 (68.6) | 8075 (66.6) | 468 (56.0) | 1.072 (1.029–1.122) | .001 | 1.279 (1.188–1.377) | < .001 |
III | 74,341 (60.6) | 7863 (52.6) | 1295 (34.6) | 1.297 (1.250–346) | < .001 | 1.519 (1.464–1.576) | < .001 |
IV | 55,675 (10.8) | 5166 (10.0) | 1274 (2.5) | 1.053 (1.020–1.087) | .001 | 1.245 (1.208–1.282) | < .001 |
Stage | Histology | Cox Regression | |||||
---|---|---|---|---|---|---|---|
AC Total No. (5-y CSS, %) | MAC Total No. (5-y CSS, %) | SRCC Total No. (5-y CSS, %) | MAC vs. AC HR (95) CI% | P Value | SRCC vs. AC HR (95) CI% | P Value | |
0-IV | 279,229 (67.8) | 23,849 (60.9) | 3184 (32.5) | 1.271 (1.242–1.302) | < .001 | 1.724 (1.685–1.765) | < .001 |
0 | 11,064 (93.7) | 65 (83.4) | 13 (83.1) | 2.592 (1.342–5.007) | .005 | 1.726 (0.862–3.455) | .123 |
I | 69,464 (91.4) | 2833 (90.1) | 165 (74.6) | 1.174 (1.027–1.341) | .018 | 1.828 (1.540–2.169) | < .001 |
II | 69,705 (81.7) | 8031 (81.6) | 465 (70.3) | 1.016 (0.957–1.079) | .604 | 1.372 (1.251–1.506) | .011 |
III | 73,923 (69.1) | 7816 (61.1) | 1285 (41.1) | 1.356 (1.300–1.415) | < .001 | 1.630 (1.565–1.697) | < .001 |
IV | 55,073 (12.4) | 5104 (11.4) | 1256 (3.2) | 2.218 (2.146–2.293) | < .001 | 1.734 (1.681–1.788) | < .001 |