Khoueir Nadim, Matar Nayla, Farah Chadi, Francis Evana, Tabchy Bassam, Haddad Amine
Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
Department of Otolaryngology Head and Neck Surgery, Hotel Dieu de France University Hospital, Saint Joseph University School of Medicine, Beirut, Lebanon.
Am J Otolaryngol. 2015 Nov-Dec;36(6):755-62. doi: 10.1016/j.amjoto.2015.07.009. Epub 2015 Jul 16.
We aim to assess the correlation of tumor and nodal staging to survival in pT3N+ and T4aN0 laryngeal cancer with subgroup analysis within stage IVa (pT4N0 and pT3N2).
Retrospective cohort study with systematic review of the literature.
Hotel Dieu de France University Hospital (tertiary referral center).
Laryngeal cancer patients' registries were reviewed from 1998 to 2012 selecting pT3N+ and pT4aN0 patients treated by primary total layngectomy. Overall survivals were compared using Log rank and Kaplan-Meier analysis. A systematic review was performed by 2 reviewers including all the articles reporting the outcome of these categories of patients. Online databases, including PubMed and EMBASE, were used. Reference sections of identified studies were examined for additional articles.
Thirteen T3N+ patients and 19 T4aN0 patients treated by primary total laryngectomy were included. Five-year overall survival for T3N+, T3N2 and T4aN0 was respectively 33%, 32.1% and 73.7%. Due to the small sample, the difference was not significant. The systematic review revealed three articles reporting overall survival outcome for the T4N0 group and 6 articles for the T3N+. At 5years, the survival ranged from 62.5% to 73% in T4N0 and from 32.2% to 77% in T3N+.
In advanced stage laryngeal cancer, T4aN0 tends toward a better survival than T3N+ especially when compared to T3N2 although they are grouped in the same TNM stage IVa.
我们旨在评估pT3N+和T4aN0喉癌患者的肿瘤和淋巴结分期与生存率的相关性，并对IVa期（pT4N0和pT3N2）进行亚组分析。
回顾性队列研究并对文献进行系统评价。
法国迪厄医院大学医疗中心（三级转诊中心）。
回顾1998年至2012年喉癌患者登记资料，选取接受原发性全喉切除术治疗的pT3N+和pT4aN0患者。采用对数秩检验和Kaplan-Meier分析比较总生存率。由两名审阅者进行系统评价，纳入所有报告此类患者结局的文章。使用在线数据库，包括PubMed和EMBASE。检查已识别研究的参考文献部分以获取其他文章。
纳入13例接受原发性全喉切除术治疗的T3N+患者和19例T4aN0患者。T3N+、T3N2和T4aN0患者的5年总生存率分别为33%、32.1%和73.7%。由于样本量小，差异无统计学意义。系统评价显示，有3篇文章报告了T4N0组的总生存结局，6篇文章报告了T3N+组的总生存结局。5年时，T4N0组的生存率为62.5%至73%，T3N+组为32.2%至77%。
在晚期喉癌中，T4aN0的生存率往往优于T3N+，尤其是与T3N2相比，尽管它们都被归为TNM分期的IVa期。
