Santos T S, Estêvão R, Antunes L, Certal V, Silva J C, Monteiro E
Department of ENT,Instituto Português de Oncologia,Porto,Portugal.
Department of Epidemiology,Instituto Português de Oncologia,Porto,Portugal.
J Laryngol Otol. 2016 Oct;130(10):948-953. doi: 10.1017/S002221511600880X.
To evaluate the clinical and histopathological factors affecting the prognosis of patients with squamous cell locoregional advanced laryngeal cancer.
A retrospective chart review was conducted of 121 patients with locoregional advanced laryngeal cancer, primarily treated with surgery from 2007 to 2011. Disease-free survival and overall survival rates were analysed as oncological outcomes. Prognostic variables, namely gender, pharyngeal invasion, pathological assessment of tumour and nodal stage, adjuvant therapy, margin status, nodal extracapsular extension, tumour differentiation, lymphovascular and perineural invasion, and predominant growth pattern, were also analysed.
One-year and three-year disease-free survival rates were 81.3 per cent and 63.5 per cent, respectively. One-year and three-year overall survival rates were 88.3 per cent and 61.4 per cent, respectively. Multivariate analysis showed that nodal extracapsular extension (p < 0.05) and an infiltrative growth pattern (p < 0.05) were associated with disease progression. Nodal extracapsular extension (p < 0.05) was associated with higher mortality.
Nodal extracapsular extension and an infiltrative growth pattern were the main prognostic factors in locoregional advanced laryngeal cancer. The presence of pharyngeal invasion, pathologically confirmed node-positive stage 2-3 disease, close or microscopic positive margins, and lymphovascular and perineural invasion have a negative impact on prognosis.
评估影响局部区域晚期喉鳞状细胞癌患者预后的临床和组织病理学因素。
对2007年至2011年主要接受手术治疗的121例局部区域晚期喉癌患者进行回顾性病历审查。将无病生存率和总生存率作为肿瘤学结局进行分析。还分析了预后变量,即性别、咽侵犯、肿瘤病理评估和淋巴结分期、辅助治疗、切缘状态、淋巴结包膜外扩展、肿瘤分化、淋巴管和神经周围侵犯以及主要生长模式。
1年和3年无病生存率分别为81.3%和63.5%。1年和3年总生存率分别为88.3%和61.4%。多变量分析显示,淋巴结包膜外扩展(p < 0.05)和浸润性生长模式(p < 0.05)与疾病进展相关。淋巴结包膜外扩展(p < 0.05)与较高的死亡率相关。
淋巴结包膜外扩展和浸润性生长模式是局部区域晚期喉癌的主要预后因素。咽侵犯、病理证实的2-3期淋巴结阳性疾病、切缘接近或显微镜下阳性以及淋巴管和神经周围侵犯的存在对预后有负面影响。