Department of Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina.
Head Neck. 2014 Mar;36(3):334-9. doi: 10.1002/hed.23294. Epub 2013 Jun 1.
The purpose of this study was to determine whether indeterminate pulmonary nodules (IPNs) at staging are predictive of lung metastasis, primary lung carcinoma, or survival in patients with advanced head and neck squamous cell carcinoma (HNSCC).
One hundred ten patients with IPN at staging who had follow-up imaging and 100 patients without IPN were identified from an HNSCC database. The primary endpoints were lung progression-free survival (PFS) and overall survival (OS).
Two-year lung PFS for the IPN and No-IPN cohorts were 66% versus 61% (p = .92) and the OS for these cohorts were 71% versus 68% (p = .77). Within the IPN cohort, level IV/V lymph node involvement (odds ratio = 4.34; p = .03), hypopharynx primary (odds ratio = 21.5; p = .005), and race (odds ratio = 9.29; p = .001) were independent predictors of developing lung malignancy.
IPNs at staging in patients with HNSCC do not affect prognosis and should neither influence initial treatment planning nor the frequency of posttreatment surveillance.
本研究旨在确定分期时的不确定肺结节（IPN）是否可预测晚期头颈部鳞状细胞癌（HNSCC）患者的肺转移、原发性肺癌或生存。
从 HNSCC 数据库中确定了 110 例分期时存在 IPN 且有随访影像学资料的患者和 100 例无 IPN 的患者。主要终点是肺无进展生存期（PFS）和总生存期（OS）。
IPN 和 No-IPN 队列的 2 年肺 PFS 分别为 66%和 61%（p =.92），OS 分别为 71%和 68%（p =.77）。在 IPN 队列中，IV/V 级淋巴结受累（优势比=4.34；p =.03）、咽后原发肿瘤（优势比=21.5；p =.005）和种族（优势比=9.29；p =.001）是发生肺恶性肿瘤的独立预测因素。
HNSCC 患者分期时的 IPN 不影响预后，既不应影响初始治疗计划，也不应影响治疗后监测的频率。
