Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City.
Department of Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine.
JAMA Otolaryngol Head Neck Surg. 2015 Jun;141(6):519-25. doi: 10.1001/jamaoto.2015.0643.
Posttreatment surveillance (PTS) is a key component in the treatment of patients with head and neck cancer. It is unclear how beneficial this is in improving patients' survival.
To determine how compliance with follow-up affects clinical outcomes in patients with head and neck squamous cell carcinoma.
DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study at a tertiary academic center of a total of 332 patients with head and neck squamous cell carcinoma who had completed both treatment and follow-up at the University of Kansas Medical Center. Patient and tumor characteristics, socioeconomic status, and geographic data were collected.
Compliance with PTS.
The effect of compliance with PTS on overall survival.
Compliance with PTS, US Census tract income level, and the distance patients travel for follow-up had significant effects on survival (P = .001, P = .001, and P = .01, respectively). Cox proportional hazard models revealed that more advanced disease (hazard ratio [HR], 1.76 [95% CI, 1.21-2.58]; P = .003), middle (HR, 1.64 [95% CI, 1.13-2.39]; P = .009) and moderate (HR, 1.90 [95% CI, 1.18-3.06]; P = .008) census tract income level, and age (HR, 1.03 [95% CI, 1.01-1.04]; P < .001), were significantly associated with an increased risk of death. There was an association between compliance and tobacco cessation (P = .003), as well as the distance a patient lived from the medical center (P = .008).
Patients with head and neck squamous cell carcinoma were significantly more likely to survive with completion of follow-up and tobacco cessation. Compliance with PTS was associated with smoking cessation and traveling less than 200 miles for follow-up.
治疗后监测 (PTS) 是头颈部癌症患者治疗的关键组成部分。目前尚不清楚这对提高患者生存率有多大益处。
确定头颈部鳞状细胞癌患者的依从性对临床结果的影响。
设计、地点和参与者：这是一项回顾性队列研究，共纳入了 332 例在堪萨斯大学医学中心完成治疗和随访的头颈部鳞状细胞癌患者，这些患者均来自三级学术中心。收集了患者和肿瘤特征、社会经济地位和地理数据。
治疗后监测的依从性。
治疗后监测依从性对总生存率的影响。
治疗后监测的依从性、美国人口普查区收入水平以及患者随访的旅行距离对生存有显著影响（P = .001，P = .001 和 P = .01，分别）。Cox 比例风险模型显示，更晚期的疾病（风险比 [HR]，1.76 [95% CI，1.21-2.58]；P = .003）、中等（HR，1.64 [95% CI，1.13-2.39]；P = .009）和中等收入水平（HR，1.90 [95% CI，1.18-3.06]；P = .008）以及年龄（HR，1.03 [95% CI，1.01-1.04]；P < .001）与死亡风险增加显著相关。依从性与戒烟（P = .003）以及患者与医疗中心的距离（P = .008）之间存在关联。
完成随访和戒烟的头颈部鳞状细胞癌患者的生存率显著提高。治疗后监测的依从性与戒烟和随访距离小于 200 英里有关。
