摘要
背景与目的:目前晚期喉鳞癌患者的预后差,针对晚期喉癌预后的相关因素的研究结果差异较大。本研究旨在总结晚期喉癌的临床特征和治疗方法,探讨影响晚期(Ⅲ～Ⅳ期)喉鳞状细胞癌患者术后生存和预后的临床病理因素。方法:回顾性分析1990年1月至2003年12月中山大学肿瘤防治中心221例晚期喉鳞癌患者的临床病理资料。应用Kaplan-Meier法分析生存结果,通过Cox回归模型确立影响患者生存预后的独立因素,并建立晚期喉鳞癌的预后模型。结果:本组221例晚期喉鳞癌患者术后的中位生存时间为96个月,2年和5年无瘤生存率分别为60.0%和43.0%;2年和5年累积生存率分别为76.9%和51.1%。Ⅲ期喉癌的无瘤和累积生存率均高于Ⅳ期;术后放疗可以提高切缘阳性患者的生存率;行部分喉切除术的患者的生存率与全喉切除术者相近。年龄、解剖分型、病理分期、手术切缘和放射治疗为影响患者无瘤生存的独立因素;而年龄、病理分期和手术切缘是影响患者累积生存率的独立因素。结论:晚期喉鳞癌患者预后差,影响患者术后累积生存率的独立因素为年龄、病理分期和手术切缘。
Background and Objective： The prognosis of advanced squamous cell carcinoma of the larynx is poor Prognostic factors of this disease vary in different studies. This study was to analyze the most important factors affecting the prognosis of the patients with advanced （stage Ⅲ and Ⅳ） squamous cell carcinoma （SCC） of the larynx. Methods. Clinical data of 221 patients with advanced SCC of the larynx were retrospectively analyzed. Survival analysis was performed by the life table method; comparison among/between groups was performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazard model. Results. The 2- and 5-year overall survival rates of the 221 patients were 76.9% and 51.1%; while the 2- and 5-year disease free survival rates were 60.0% and 43.0%. Patients in stage Ⅲ had better prognosis than those in stage Ⅳ. Post-operative radiotherapy improved the survival rate in patients with positive surgical margins. There was no difference in the survival rate between patients underwent partial laryngectomy and those underwent total laryngectomy. Multivariate analyses indicated that age, anatomic type, postsurgical stage, surgical margin and radiotherapy influenced the disease free survival （P〈0.05）, whereas, age, post-surgical stage and surgical margin affected the overall survival （P〈0.05）. Conclusions. The prognosis of patients with advanced SCC of the larynx receiving surgery is poor. Age, post-surgical stage and surgical margin are the most important factors affecting the overall survival.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2009年第3期297-302,共6页
Chinese Journal of Cancer
关键词
喉肿瘤
鳞状细胞癌
生存分析
预后因素
laryngeal carcinoma, squamous cell carcinoma, survival analysis, prognosis
