喉癌复发的预测因素及治疗结果

Predictive factors and treatment outcome of laryngeal carcinoma recurrence.

作者信息

Haapaniemi Aaro, Väisänen Janne, Atula Timo, Alho Olli-Pekka, Mäkitie Antti, Koivunen Petri

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Department of Otorhinolaryngology - Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.

出版信息

Head Neck. 2017 Mar;39(3):555-563. doi: 10.1002/hed.24642. Epub 2016 Nov 30.

DOI:10.1002/hed.24642

PMID:27902867

Abstract

BACKGROUND

Up to 30% of patients with laryngeal squamous cell carcinoma (SCC) present with recurrence after treatment. We analyzed factors associated with the risk of cancer recurrence and prognosis after recurrence.

METHODS

A nationwide laryngeal SCC cohort from Finnish university hospitals during 2001 to 2005 with initial successful therapy (n = 316) was analyzed.

RESULTS

Laryngeal SCC recurred in 22% of patients. The median time to recurrence was 9 months, with 90% occurring within 36 months after treatment. The World Health Organization (WHO) performance status >0, neck metastasis at presentation, and nonsurgical treatment were independent prognostic factors for recurrence. Patients with local recurrence had a 5-year overall survival (OS) of 53% compared with 5% in patients with regional/distant recurrences. OS for glottic and nonglottic laryngeal SCC recurrence was 45% and 0%, respectively.

CONCLUSION

The type of treatment affected the risk of recurrence in this retrospective series. Local recurrences carried a chance for successful salvage treatment. Routine follow-up beyond 36 months remains controversial. © 2016 Wiley Periodicals, Inc. Head Neck 39: 555-563, 2017.

摘要

背景

高达30%的喉鳞状细胞癌（SCC）患者在治疗后会出现复发。我们分析了与癌症复发风险及复发后预后相关的因素。

方法

对2001年至2005年期间来自芬兰大学医院的一个全国性喉SCC队列进行分析，这些患者初始治疗成功（n = 316）。

结果

22%的患者出现喉SCC复发。复发的中位时间为9个月，90%的复发发生在治疗后36个月内。世界卫生组织（WHO）体能状态>0、初诊时颈部转移以及非手术治疗是复发的独立预后因素。局部复发患者的5年总生存率（OS）为53%，而区域/远处复发患者为5%。声门型和非声门型喉SCC复发的OS分别为45%和0%。