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喉癌不进行喉切除术、放疗或化疗的生存分析。

Survival analysis of laryngeal carcinoma without laryngectomy, radiotherapy, or chemotherapy.

机构信息

Department of Otolaryngology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China.

出版信息

Eur Arch Otorhinolaryngol. 2012 Sep;269(9):2103-9. doi: 10.1007/s00405-011-1873-7. Epub 2011 Dec 21.

Abstract

This study aimed at investigating the survival rate and prognostic factors of laryngeal carcinoma patients in the absence of the use of laryngectomy, radiotherapy, and chemotherapy. A total of 167 cases of laryngeal carcinoma without the use of laryngectomy, radiotherapy, or chemotherapy were analyzed retrospectively. Surveyed items included age, smoking history, tumor family history, tuberculosis history, primary site, pathological grade, T-stage, N-stage, clinical stage, and whether tracheotomy had been performed. Survival rates were calculated using the Kaplan-Meier method. For univariate analysis, comparison among/between groups was performed using the log-rank test. Multivariate analysis was carried out using the Cox proportional hazard model. Overall median survival time was 16 ± 1.44 months, and overall 1- and 2-year survival rates were 56.4 and 26.5%, respectively. No patient survived over 5 years in cases diagnosed for more than 5 years (except for cases that were lost). The median survival time of clinical stage 0/I/II was 28 ± 3.81 months, and 1- and 2-year survival rates were 79.3 and 59.3%, respectively; the median survival time of III/IV clinical stages was 11 ± 1.32 months, and 1- and 2-year survival rates were 45.5 and 10.6%, respectively. Univariate analysis showed that primary site, pathological grade, T-stage, N-stage, and clinical stage were significant prognostic factors for the survival of the patients (P < 0.05). Whether tracheotomy had been performed was not significant for affecting survival rates. Multivariate analysis showed survival rates were statistically correlated with T-stage and N-stage (P < 0.05). The development of laryngeal carcinoma course was faster, without treatment to the tumor itself, even if palliative surgery such as tracheostomy would not improve the survival rate. In laryngeal carcinoma patients with no surgery, radiotherapy or chemotherapy, the factors affecting the survival rates include primary site, pathological grade, T-stage, N-stage, and clinical stage, and of them, T-stage and N-stage are the independent prognostic factors.

摘要

本研究旨在探讨未经喉切除术、放疗和化疗的喉癌患者的生存率和预后因素。回顾性分析了 167 例未经喉切除术、放疗和化疗的喉癌患者。调查项目包括年龄、吸烟史、肿瘤家族史、结核病史、原发部位、病理分级、T 分期、N 分期、临床分期以及是否进行气管切开术。采用 Kaplan-Meier 法计算生存率。单因素分析采用对数秩检验比较组间差异。多因素分析采用 Cox 比例风险模型。总中位生存时间为 16±1.44 个月,总 1 年和 2 年生存率分别为 56.4%和 26.5%。诊断超过 5 年且无存活者(除失访者外)。临床分期 0/I/II 期的中位生存时间为 28±3.81 个月,1 年和 2 年生存率分别为 79.3%和 59.3%;III/IV 期的中位生存时间为 11±1.32 个月,1 年和 2 年生存率分别为 45.5%和 10.6%。单因素分析显示,原发部位、病理分级、T 分期、N 分期和临床分期是影响患者生存的显著预后因素(P<0.05)。是否行气管切开术对生存率无显著影响。多因素分析显示,生存率与 T 分期和 N 分期显著相关(P<0.05)。喉癌患者未经手术、放疗和化疗,影响生存率的因素包括原发部位、病理分级、T 分期、N 分期和临床分期,其中 T 分期和 N 分期是独立的预后因素。

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