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成年头颈部肉瘤患者临床预后因素分析

Analysis of clinical prognostic factors for adult patients with head and neck sarcomas.

作者信息

Chang Amy E, Chai Xiaoyu, Pollack Seth M, Loggers Elizabeth, Rodler Eve, Dillon Jasjit, Parvathaneni Upendra, Moe Kris S, Futran Neal, Jones Robin L

机构信息

University of Washington School of Medicine, Seattle, Washington, USA.

Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.

出版信息

Otolaryngol Head Neck Surg. 2014 Dec;151(6):976-83. doi: 10.1177/0194599814551539. Epub 2014 Sep 25.

Abstract

OBJECTIVE

To evaluate the treatment, outcome, and prognostic factors in patients with head and neck sarcomas treated in an academic medical center.

STUDY DESIGN

Case series.

SETTING

Academic medical center.

SUBJECTS AND METHODS

We performed a retrospective analysis of adult patients (n = 97) with primary head and neck sarcomas treated between 2000 and 2012. We analyzed the treatment, outcome, and potential factors predictive of disease-free survival and disease-specific survival. We also evaluated the outcome and prognostic factors in patients with bone and soft tissue sarcomas.

RESULTS

The median overall survival was 6.8 years, with 2-year and 5-year overall survival rates of 78% (95% confidence interval [CI], 66%-86%) and 59% (95% CI, 44%-72%), respectively. Univariable analysis revealed that age at diagnosis (>60 years: hazard ratio [HR], 2.7; 95% CI, 1.2-6.2; P = .01), surgical intervention (HR, 8.3; 95% CI, 3.5-19.5; P < .001), and metastatic disease (HR, 4.3; 95% CI, 1.3-13.6; P = .01) were significantly associated with disease-specific survival.

CONCLUSION

In this study, patients over the age of 60 years at diagnosis and those with inoperable disease at initial presentation had significantly worse disease-specific survival. Surgical intervention remains the optimal treatment modality for those with resectable disease and was associated with significantly better survival in this heterogeneous series. Further multi-institutional studies are required to better define prognostic factors in individual histological subtypes.

摘要

目的

评估在一所学术性医学中心接受治疗的头颈部肉瘤患者的治疗情况、结局及预后因素。

研究设计

病例系列研究。

研究地点

学术性医学中心。

研究对象与方法

我们对2000年至2012年间接受治疗的97例原发性头颈部肉瘤成年患者进行了回顾性分析。我们分析了治疗情况、结局以及预测无病生存期和疾病特异性生存期的潜在因素。我们还评估了骨肉瘤和软组织肉瘤患者的结局及预后因素。

结果

中位总生存期为6.8年,2年和5年总生存率分别为78%(95%置信区间[CI],66%-86%)和59%(95%CI,44%-72%)。单因素分析显示,诊断时年龄(>60岁:风险比[HR],2.7;95%CI,1.2-6.2;P = 0.01)、手术干预(HR, 8.3;95%CI,3.5-19.5;P < 0.001)和转移性疾病(HR, 4.

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