Lee Chul Hee, Hur Dong Gu, Roh Hwan-Jung, Rha Ki-Sang, Jin Hong-Ryul, Rhee Chae-Seo, Min Yang-Gi
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
Arch Otolaryngol Head Neck Surg. 2007 Feb;133(2):131-4. doi: 10.1001/archotol.133.2.131.
To investigate the validity of the sixth edition of the American Joint Committee on Cancer (AJCC) staging system for sinonasal squamous cell carcinoma.
A 15-year retrospective case series review.
Multicenter study from tertiary care facilities.
Data from 113 patients diagnosed as having and treated for sinonasal squamous cell carcinoma from September 1988 through August 2003 were retrieved. Ninety patients followed up for at least 12 months were included in the study.
The TNM staging system and survival rates were analyzed using the Kaplan-Meier method to determine the mean, disease-free, and 5-year survival statistics. The effect of tumor stage on overall survival was assessed with stages defined by the fifth and sixth editions of the AJCC staging systems.
The overall 5-year survival rate was 59.5%. According to the sixth edition, the survival rates of patients with stages III, IVA, and IVB tumors showed a significant difference (P = .002). In 32 cases, the stages were changed in accordance with the criteria in the sixth edition. The group in which the stage changed from III (fifth edition) to IVA (sixth edition) showed a worse survival rate than the group in which the stage did not change, although the difference was statistically insignificant. The 5-year disease-free survival rates of the group in which the stage did not change and of the group in which the stage changed from III (fifth edition) to IVA (sixth edition) were 64% and 34%, respectively (P = .08). Local recurrence was more frequently observed in the group in which the stage changed from III (fifth edition) to IVA (sixth edition).
The new AJCC staging system seems to be more accurate in predicting the survival rates for patients with advanced but surgically resectable sinonasal squamous cell carcinoma (stage IVA).
探讨美国癌症联合委员会（AJCC）第六版鼻窦鳞状细胞癌分期系统的有效性。
一项为期15年的回顾性病例系列研究。
来自三级医疗保健机构的多中心研究。
检索了1988年9月至2003年8月期间诊断为鼻窦鳞状细胞癌并接受治疗的113例患者的数据。90例随访至少12个月的患者纳入研究。
采用Kaplan-Meier法分析TNM分期系统和生存率，以确定平均、无病和5年生存统计数据。用AJCC分期系统第五版和第六版定义的分期评估肿瘤分期对总生存的影响。
总5年生存率为59.5%。根据第六版，Ⅲ期、IVA期和IVB期肿瘤患者的生存率有显著差异（P = 0.002）。32例患者的分期根据第六版标准发生了变化。分期从Ⅲ期（第五版）变为IVA期（第六版）的组的生存率低于分期未改变的组，尽管差异无统计学意义。分期未改变的组和分期从Ⅲ期（第五版）变为IVA期（第六版）的组的5年无病生存率分别为64%和34%（P = 0.08）。分期从Ⅲ期（第五版）变为IVA期（第六版）的组局部复发更常见。
新的AJCC分期系统在预测晚期但可手术切除的鼻窦鳞状细胞癌（IVA期）患者的生存率方面似乎更准确。
