Department of Radiation Oncology, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Cancer Res Treat. 2016 Oct;48(4):1167-1176. doi: 10.4143/crt.2015.379. Epub 2016 Mar 3.
We investigated the prognostic factors for distant metastasis (DM) in patients with locally advanced oropharyngeal cancer (OPC) treated with surgery and adjuvant radiotherapy with or without concurrent chemotherapy.
Eighty-five patients treated between January 1995 and August 2014 were evaluated retrospectively. Data regarding the pathological tumour and nodal status, human papillomavirus (HPV) status, treatment characteristics, and pretreatment maximum standardized uptake value (SUVmax) of 18-fluoro-2-deoxyglucose positron emission tomography-computed tomography scan (F-FDG PET-CT) were evaluated, and their influence on DM and survival outcomes were analyzed.
Median follow-up period was 48.0 months. Recurrence was observed in 20 patients, including locoregional recurrence and DM. DM was observed in 13 patients. A multivariate analysis confirmed that the presence of lymphovascular invasion (p=0.031), lower neck lymph node (LN) involvement (p=0.006), SUVmax ≥ 9.7 (p=0.014), and tumour size ≥ 3 cm (p=0.037) significantly affected DM. HPV status was not associated with DM. Perineural invasion (p=0.048), lower neck LNinvolvement (p=0.008), SUVmax ≥ 9.7 (p=0.019), and tumour size ≥ 3 cm (p=0.033) were also significant factors for the DM-free survival rate.
Lower neck LN involvement, high SUVmax in pretreatment F-FDG PET-CT, and large tumour size were predictive factors for DM in patients of OPC.
我们研究了手术联合辅助放疗（同步或序贯化疗）治疗局部晚期口咽癌（OPC）患者远处转移（DM）的预后因素。
回顾性评估了 1995 年 1 月至 2014 年 8 月期间治疗的 85 例患者。评估了病理肿瘤和淋巴结状态、人乳头瘤病毒（HPV）状态、治疗特征以及 18-氟-2-脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（F-FDG PET-CT）的预处理最大标准化摄取值（SUVmax）的数据，并分析了其对 DM 和生存结果的影响。
中位随访时间为 48.0 个月。20 例患者出现复发，包括局部区域复发和 DM。13 例患者发生 DM。多变量分析证实，存在血管淋巴管侵犯（p=0.031）、较低颈部淋巴结（LN）受累（p=0.006）、SUVmax≥9.7（p=0.014）和肿瘤大小≥3cm（p=0.037）显著影响 DM。HPV 状态与 DM 无关。神经周围侵犯（p=0.048）、较低颈部 LN 受累（p=0.008）、SUVmax≥9.7（p=0.019）和肿瘤大小≥3cm（p=0.033）也是 DM 无复发生存率的显著因素。
较低颈部 LN 受累、预处理 F-FDG PET-CT 中 SUVmax 高以及肿瘤体积大是 OPC 患者发生 DM 的预测因素。
