Albano Pia Marie, Lumang-Salvador Christianne, Orosa Jose, Racelis Sheryl, Leano Modesty, Angeles Lara Mae, Ramos John Donnie
Research Center for the Natural and Applied Sciences, University of Santo Tomas, Manila, Philippines E-mail :
Asian Pac J Cancer Prev. 2013;14(8):4769-74. doi: 10.7314/apjcp.2013.14.8.4769.
This paper is the first to present the incidence and overall survival of patients with squamous cell carcinoma of the head and neck (SCCHN) from the extreme northern part of the Philippines. We retrospectively retrieved the records of patients with histologically-confirmed squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx and larynx at the Mariano Marcos Memorial Hospital and Medical Center, Ilocos Norte, Philippines, from 2003 to 2012 and analysed prognostic factors associated with survival. Of the 150 cases, only 80 (53.3%) were still living when the study was terminated. Median age at initial diagnosis was 61.5 years and the male to female ratio was 7:3. The majority of the cases had tumours in the oral cavity (50.7%), followed by the larynx (36.7%). Sex (log rank=1.94, p value/α=0.16), tumor site (log rank=0.02, p value/α=0.90), tumor grade (log rank=1.74, p value/α=0.42), and node stage (log rank=0.07, p value/α=0.80) were not shown to be associated with the survival of our cases. Only 45 (30.0%) had no regional lymph node involvement (N0) at presentation and 12 (8.0%) had already developed distant metastases. Among the 150 patients, 71 (47.3%) were not able to receive treatment of any kind. Oddly, treatment (log rank=1.65, p value/α=0.20) was also shown to be not associated with survival. The survival rate of those who underwent surgery, radiotherapy, or both was not statistically different from those who did not receive any treatment. Only the tumor stage (log rank=4.51, p value/α=0.03) was associated with patient survival. The overall mean survival was 49.3 months, with survival rate diminishing from 88.3% during the 1st year to 1.80% by end of the study. This relatively low survival rate of our cases only reflects their poor access to quality diagnostic and treatment facilities.
本文首次呈现了菲律宾最北部地区头颈部鳞状细胞癌（SCCHN）患者的发病率及总生存率。我们回顾性检索了2003年至2012年期间菲律宾北伊罗戈斯省马里亚诺·马科斯纪念医院和医疗中心经组织学确诊的口腔、口咽、下咽和喉鳞状细胞癌患者的记录，并分析了与生存相关的预后因素。在这150例病例中，研究结束时仅有80例（53.3%）仍存活。初次诊断时的中位年龄为61.5岁，男女比例为7:3。大多数病例的肿瘤位于口腔（50.7%），其次是喉部（36.7%）。性别（对数秩检验=1.94，p值/α=0.16）、肿瘤部位（对数秩检验=0.02，p值/α=0.90）、肿瘤分级（对数秩检验=1.74，p值/α=0.42）和淋巴结分期（对数秩检验=0.07，p值/α=0.80）均未显示与我们病例的生存相关。仅45例（30.0%）在就诊时无区域淋巴结受累（N0），12例（8.0%）已发生远处转移。在这150例患者中，71例（47.3%）无法接受任何形式的治疗。奇怪的是，治疗（对数秩检验=1.65，p值/α=0.20）也显示与生存无关。接受手术、放疗或两者皆有的患者的生存率与未接受任何治疗的患者在统计学上无差异。仅肿瘤分期（对数秩检验=4.51，p值/α=0.03）与患者生存相关。总体平均生存时间为49.3个月，生存率从第1年的88.3%降至研究结束时的1.80%。我们病例相对较低的生存率仅反映了他们难以获得高质量的诊断和治疗设施。
