转移性头颈部皮肤鳞状细胞癌伴颈部淋巴结转移患者的预后预测因素：辅助放疗可改善生存。
Predictors of outcome in patients with metastatic cutaneous head and neck squamous cell carcinoma involving cervical lymph nodes: Improved survival with the addition of adjuvant radiotherapy.
机构信息
Department of Radiation Oncology, Head and Neck Cancer Service, Westmead Hospital, University of Sydney, Sydney, New South Wales, 2145, Sydney, Australia.
出版信息
Head Neck. 2012 Nov;34(11):1524-8. doi: 10.1002/hed.21965. Epub 2011 Nov 23.
BACKGROUND
The purpose of this study was to compare the outcome of surgery against surgery plus radiotherapy in patients with metastatic cutaneous head and neck squamous cell carcinoma (HNSCC) to cervical nodes.
METHODS
We conducted a 28-year retrospective analysis of 122 patients whom were treated for metastatic cutaneous HNSCC involving the cervical nodes (levels I-V).
RESULTS
After surgery alone, 11 patients (55%) developed recurrence compared with 23 patients (23%) after surgery plus radiotherapy. On multivariate analysis, the following variables were significantly associated with disease-free survival (DFS): immunosuppression (p = .002), treatment modality (p < .001), extracapsular spread (p = .009), and pathological nodal stage (p = .04). Patients undergoing surgery plus radiotherapy had a significantly better 5-year DFS (74% vs 34%; p = .001) and 5-year overall survival (OS; 66% vs 27%; p = .003) compared with surgery alone.
CONCLUSION
In patients with metastatic cutaneous HNSCC involving cervical nodes, survival was significantly improved with the addition of radiotherapy.
背景
本研究旨在比较手术与手术加放疗治疗转移性皮肤头颈部鳞状细胞癌（HNSCC）颈部淋巴结转移患者的结局。
方法
我们对 122 例接受转移性皮肤 HNSCC 颈部淋巴结（I-V 区）治疗的患者进行了 28 年的回顾性分析。
结果
单独手术后，11 例（55%）患者出现复发，而手术后加放疗的患者有 23 例（23%）出现复发。多因素分析显示，无疾病生存（DFS）的相关变量有：免疫抑制（p=0.002）、治疗方式（p<0.001）、囊外扩散（p=0.009）和病理淋巴结分期（p=0.04）。与单独手术相比，接受手术加放疗的患者 5 年 DFS（74% vs 34%；p=0.001）和 5 年总生存（OS）（66% vs 27%；p=0.003）显著提高。
结论
对于转移性皮肤 HNSCC 颈部淋巴结转移患者，放疗的加入显著提高了生存率。
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