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鼻窦鳞状细胞癌:临床结果与预测因素

Sinonasal squamous cell carcinomas: clinical outcomes and predictive factors.

作者信息

Michel J, Fakhry N, Mancini J, Braustein D, Moreddu E, Giovanni A, Dessi P

机构信息

Department of Otolaryngology - Head and Neck Surgery, Aix-Marseille University, La Timone University Hospital, Marseille, France.

Department of Otolaryngology - Head and Neck Surgery, Aix-Marseille University, La Timone University Hospital, Marseille, France.

出版信息

Int J Oral Maxillofac Surg. 2014 Jan;43(1):1-6. doi: 10.1016/j.ijom.2013.07.741. Epub 2013 Aug 17.

Abstract

This was a retrospective study of 33 patients treated for sinonasal squamous cell carcinoma between 1995 and 2008. Epidemiological, clinical, histological, and therapeutic aspects of this series of patients were analysed, and their impacts on overall survival and disease-free survival established using the Kaplan-Meier method. A search for prognostic factors was made using a log-rank test. There were 27 men. The average age at diagnosis was 64.7 years. Tobacco-smoking was found to be a risk factor in 24 patients (72.7%). The median follow-up was 66 months (range 0-99 months). Tumours were classified as T1 in 18.3%, T2 in 27.3%, T3 in 6%, and T4 in 48.5% of cases. Disease-free survival rates at 1 and 5 years were 58.5% and 46.1%, respectively, and overall survival rates were 70.3% and 40%, respectively. Overall survival was correlated to tumour status (TNM, American Joint Committee on Cancer) (P = 0.010) and involvement of key structures (skull base, dura mater, brain, orbit, cavernous sinus, infratemporal fossa, skin) (P = 0.049). Surgery followed by radiotherapy improved overall survival (P = 0.005) and disease-free survival (P = 0.028) when compared to other treatment modalities. When compared to surgery alone, it improved disease-free survival (P = 0.049) regardless of tumour stage.

摘要

这是一项对1995年至2008年间接受鼻窦鳞状细胞癌治疗的33例患者的回顾性研究。分析了该系列患者的流行病学、临床、组织学和治疗方面,并使用Kaplan-Meier方法确定了它们对总生存期和无病生存期的影响。使用对数秩检验寻找预后因素。其中男性27例。诊断时的平均年龄为64.7岁。发现24例患者(72.7%)吸烟是一个危险因素。中位随访时间为66个月(范围0 - 99个月)。肿瘤分类为T1的占18.3%,T2的占27.3%,T3的占6%,T4的占48.5%。1年和5年的无病生存率分别为58.5%和46.1%,总生存率分别为70.3%和40%。总生存期与肿瘤状态(TNM,美国癌症联合委员会)相关(P = 0.010),与关键结构(颅底、硬脑膜、脑、眼眶、海绵窦、颞下窝、皮肤)受累相关(P = 0.049)。与其他治疗方式相比,手术加放疗可提高总生存期(P = 0.005)和无病生存期(P = 0.028)。与单纯手术相比,无论肿瘤分期如何,它均可提高无病生存期(P = 0.049)。

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