Kazmi Faraz Nasim, Adil Amina, Ghaffar Shehzad, Ahmed Farhan
Aga Khan University Hospital, Karachi, Pakistan.
J Pak Med Assoc. 2012 Nov;62(11):1129-33.
To evaluate the prognostic significance of computerized tomography derived tumour volume for squamous cell cancers of the head and neck, treated primarily by surgery.
The retrospective review study comprised 72 patients with head and neck malignancies who were treated primarily by surgery at Aga Khan University Hospital, Karachi, with/without adjuvant. It was done from May 2007 to November 2008. Each patient was followed up for a minimum of one year to check for recurrence. For statistical analysis SPSS 17 was used. Frequencies, cross-tabulations with chi square tests to find associations, binary logistic regression analysis, Cox regression analysis and receiver operating characteristic curve tests were run on the data.
Overall, the median tumour volume for patients with recurrent disease was 52cm3 compared to 22cm3 for those who did not have a recurrence. It was found that large tumour volume was associated with a significantly higher chance of recurrence (p = 0.009). Laryngeal cancers with volumes greater than 46cm3 and oral cancers with volumes greater than 23.1cm3 were associated with poor prognosis.
The primary tumour volume can represent an important prognostic factor for treatment outcome. Patients with larger primary tumour volumes should be treated more aggressively.
评估计算机断层扫描得出的肿瘤体积对头颈部鳞状细胞癌（主要接受手术治疗）的预后意义。
这项回顾性研究纳入了72例头颈部恶性肿瘤患者，这些患者于2007年5月至2008年11月在卡拉奇阿迦汗大学医院主要接受手术治疗，部分接受或未接受辅助治疗。对每位患者进行至少一年的随访以检查是否复发。使用SPSS 17进行统计分析。对数据进行频率分析、采用卡方检验的交叉表分析以找出关联、二元逻辑回归分析、Cox回归分析以及受试者工作特征曲线测试。
总体而言，复发患者的肿瘤体积中位数为52cm³，未复发患者为22cm³。发现肿瘤体积大与复发几率显著更高相关（p = 0.009）。体积大于46cm³的喉癌和体积大于23.1cm³的口腔癌与预后不良相关。
原发肿瘤体积可代表治疗结果的一个重要预后因素。原发肿瘤体积较大的患者应接受更积极的治疗。
