Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Baylor College of Medicine, Houston, Texas 77030, USA.
Clin Cancer Res. 2010 Oct 15;16(20):5019-27. doi: 10.1158/1078-0432.CCR-10-0755. Epub 2010 Oct 13.
PURPOSE: It is unknown whether there are survival disparities between men and women with squamous cell carcinoma of the head and neck (SCCHN), although some data suggest that men have worse outcomes. We conducted a matched-pair study that controlled for several potentially confounding prognostic variables to assess whether a survival advantage exists for female compared with male SCCHN patients receiving similar care. EXPERIMENTAL DESIGN: We selected 286 female patients and 286 matched male patients from within a prospective epidemiologic study on 1,654 patients with incident SCCHN evaluated and treated at a single large multidisciplinary cancer center. Matching variables included age (±10 y), race/ethnicity, smoking status (never versus ever), tumor site (oral cavity versus oropharynx versus larynx versus hypopharynx), tumor classification (T(1-2) versus T(3-4)), nodal status (negative versus positive), and treatment (surgery, radiation therapy, surgery and radiation therapy, surgery and chemotherapy, chemoradiotherapy, or surgery and chemoradiotherapy). RESULTS: Matched-pair and log-rank analyses showed no significant differences between women and men in recurrence-free, disease-specific, or overall survival. When the analysis was restricted to individual sites (oral cavity, oropharynx, or larynx/hypopharynx), there was also no evidence of a disparity in survival associated with sex. CONCLUSIONS: We conclude that there is no evidence to suggest that a survival advantage exists for women as compared with men with SCCHN receiving similar multidisciplinary directed care at a tertiary cancer center.
目的:尽管有数据表明男性的预后较差,但目前尚不清楚头颈部鳞状细胞癌(SCCHN)患者的性别是否存在生存差异。我们进行了一项配对研究,通过控制多个潜在的混杂预后变量,以评估在接受类似多学科治疗的情况下,女性与男性 SCCHN 患者相比是否存在生存优势。
实验设计:我们从一家大型多学科癌症中心评估和治疗的 1654 例新发 SCCHN 患者的前瞻性流行病学研究中选择了 286 例女性患者和 286 例匹配的男性患者。匹配变量包括年龄(±10 岁)、种族/民族、吸烟状况(从不吸烟与曾经吸烟)、肿瘤部位(口腔、口咽、喉、下咽)、肿瘤分类(T1-2 与 T3-4)、淋巴结状态(阴性与阳性)和治疗方法(手术、放疗、手术加放疗、手术加化疗、放化疗、手术加放化疗)。
结果:配对和对数秩分析显示,女性和男性在无复发生存、疾病特异性生存或总生存方面无显著差异。当分析仅限于特定部位(口腔、口咽、喉/下咽)时,性别与生存差异也没有关联。
结论:我们的结论是,没有证据表明在接受类似多学科治疗的三级癌症中心中,女性与男性 SCCHN 患者相比存在生存优势。
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