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221例晚期喉鳞状细胞癌患者手术治疗的生存及预后分析

[Survival and prognostic analysis of 221 patients with advanced laryngeal squamous cell carcinoma treated by surgery].

作者信息

Liu Tian-Run, Yang An-Kui, Chen Fu-Jin, Zeng Mu-Sheng, Song Ming, Guo Zhu-Ming, Chen Wen-Kuan, Ouyang Dian, Li Qiu-Li, Chen Yan-Feng, Zhang Quan, Zeng Zong-Yuan

机构信息

Key Laboratory of Oncology in South China, Guangzhou, Guangdong, P. R. China.

出版信息

Ai Zheng. 2009 Mar;28(3):297-302.

Abstract

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 two- and five-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, post-surgical 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.

摘要

背景与目的

晚期喉鳞状细胞癌预后较差,不同研究中该疾病的预后因素有所不同。本研究旨在分析影响晚期(Ⅲ期和Ⅳ期)喉鳞状细胞癌患者预后的最重要因素。

方法

回顾性分析221例晚期喉鳞状细胞癌患者的临床资料。采用寿命表法进行生存分析;组间比较采用对数秩检验;多因素分析采用Cox比例风险模型。

结果

221例患者的2年和5年总生存率分别为76.9%和51.1%;2年和5年无病生存率分别为60.0%和43.0%。Ⅲ期患者的预后优于Ⅳ期患者。手术切缘阳性患者术后放疗可提高生存率。行部分喉切除术与全喉切除术患者的生存率无差异。多因素分析表明,年龄、解剖类型、术后分期、手术切缘及放疗影响无病生存(p<0.05),而年龄、术后分期及手术切缘影响总生存(p<0.05)。

结论

接受手术治疗的晚期喉鳞状细胞癌患者预后较差。年龄、术后分期及手术切缘是影响总生存的最重要因素。

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