摘要
目的:分析局部晚期声门型喉癌术后在病理学上测量的肿瘤体积和患者的总生存率(OS)和无病生存率(DFS)的关系。方法:收集2005年1月-2010年12月接受手术±放/化疗的406例T3~T4期声门型喉鳞状细胞癌患者的病理和临床数据并进行随访。统计患者的临床信息,计算术后病理肿瘤体积,ROC曲线获取二分类最佳界值。Logistic回归模型分析患者的肿瘤体积与T分期的关系,Cox回归模型分析肿瘤体积与OS和DFS的关系。结果:406例声门型喉癌患者5年和10年的OS分别为62.9%和55.4%,DFS分别为55.5%和50.8%。肿瘤体积为(5.1±6.7) cm3,T4期患者的肿瘤体积较T3期大(P<0.001)。Logistic回归模型发现肿瘤体积和T分期具有相关性,影响T分期(OR=13.81,95%CI:6.03~31.59,P<0.001)。ROC曲线获得OS和DFS的肿瘤体积的最佳界值为3 cm3,肿瘤体积≤3 cm3患者的OS和DFS高于肿瘤体积>3 cm3的患者(P<0.001)。采用Cox回归模型排除混杂因素,发现肿瘤体积是影响患者OS和DFS的独立危险因素(OS:HR=1.59,95%CI:1.09~2.32,P=0.017;DFS:HR=1.54,95%CI:1.08~2.20,P=0.016)。结论:肿瘤体积和T分期具有相关性,是影响局部晚期声门型喉癌患者生存率的独立危险因素。
Objective: The aim of this study was to evaluate the predicting role of tumor volume as evaluated by postoperative pathologic examination on overall survival(OS) and disease free survival(DFS) in patients with local advanced glottic carcinoma. Methods: In this study, the records of 406 consecutive patients with local advanced glottic carcinoma(T3-T4 stages) who underwent surgery ± chemoradiotherapy from January 2005 to December 2010 were retrospectively reviewed and followed up. The demographic characteristics, disease staging, and pathologic tumor volume were analyzed. The optimal cutoff values of tumor volume for OS and DFS were obtained by using receiver operating characteristic(ROC) curves. The association of tumor volume with T stages were assessed by using Logistic regression model, and the relationship between tumor volume and OS and DFS rates were evaluated by using Cox regression models. Results: The 5-and 10-year OS rates were 62.9% and 55.4%, respectively. The 5-and 10-year DFS rates were 55.5% and 50.8%, respectively. The mean tumor volume was(5.1±6.7) cm3, T4 stage patients had higher tumor volume than those of patients with T3 stage(P<0.001). The factor of tumor volume was correlated with T stages by using Logistic regression analyses(OR=13.81, 95%CI: 6.03-31.59, P<0.001). The optimal cutoff values of tumor volume that were both at 3 cm3 for OS and DFS rates were obtained by using ROC curve plots. The OS and DFS rates of glottic carcinoma patients with tumor volume ≤ 3 cm3 were better when compared with those of patients with tumor volume>3 cm3(P<0.001). Upon multivariate analyses, tumor volume was strongly correlated with poorer OS and DFS rates and remained independent prognostic factors for both the OS and DFS of patients with glottic carcinoma(OS: HR=1.59, 95%CI: 1.09-2.32, P=0.017;DFS: HR=1.54, 95%CI: 1.08-2.20, P=0.016). Conclusion: This study demonstrates that tumor volume is correlated with T stages, and this factor is an independent predictive factor of survival outcomes in patients wit
作者
龚洪立
周梁
陶磊
张明
吴海涛
陈小玲
李筱明
李采
周健
GONG Hongli;ZHOU Liang;TAO Lei;ZHANG Ming;WU Haitao;CHEN Xiaoling;LI Xiaoming;LI Cai;ZHOU Jian(Department of Otolaryngology Head and Neck Surgery,Eye&ENT Hospital of Fudan University,Shanghai,200031,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2021年第4期316-320,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
上海市申康医院发展中心临床科技创新项目(No:SHDC12015114)
上海市2016年度“科技创新行动计划”医学领域项目(No:16411950101)
上海市“医苑新星”青年医学人才培养资助项目(No:沪卫计人事[2019]72号)。
关键词
喉肿瘤
肿瘤体积
生存率
laryngeal neoplasms
tumor volume
survival rate
