胆脂瘤的发病率、10年复发率及预后因素

Incidence, 10-year recidivism rate and prognostic factors for cholesteatoma.

作者信息

Britze A, Møller M L, Ovesen T

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery,Aarhus Universitetshospital,Denmark.

Department of Clinical Medicine,Aarhus University,Denmark.

出版信息

J Laryngol Otol. 2017 Apr;131(4):319-328. doi: 10.1017/S0022215117000299.

DOI:10.1017/S0022215117000299

PMID:28244845

Abstract

OBJECTIVE

Cholesteatoma patients have a high risk of recurrence with complications, and knowledge exchange is a prerequisite for improving treatment. This study aimed to apply appropriate statistics to provide meaningful and transferable results from cholesteatoma surgery, to highlight independent prognostic factors, and to assess the incidence rate.

METHODS

Incidence rates were assessed for the district of Aarhus, Denmark. From 147 patients operated on mainly with canal wall up mastoidectomies for debuting cholesteatomas, 10-year Kaplan-Meier recidivism rates were calculated and independent prognostic factors for the recidivism were identified by Cox multivariate regression analyses.

RESULTS

Incidence rate was 6.8 per 100 000 per year. The 10-year cumulative recidivism rate was 0.44 (95 per cent confidence interval, 0.37-0.53). Independent prognostic factors for the recidivism were: age below 15 years (hazard ratio = 2.2; p > z = 0.002), cholesteatoma localised to the mastoid (hazard ratio = 1.7; p > z = 0.04), stapes erosion (hazard ratio = 1.9; p > z = 0.02) and incus erosion (hazard ratio = 1.9; p > z = 0.04).

CONCLUSION

The recidivism rate is influenced by several factors that are important to observe, both in the clinic and when comparing results from surgery.

摘要

目的

胆脂瘤患者复发并伴有并发症的风险很高，知识交流是改善治疗的前提条件。本研究旨在应用适当的统计学方法，以提供来自胆脂瘤手术的有意义且可推广的结果，突出独立的预后因素，并评估发病率。

方法

对丹麦奥胡斯地区的发病率进行了评估。从147例主要接受开放式乳突根治术治疗初发性胆脂瘤的患者中，计算了10年的Kaplan-Meier复发率，并通过Cox多变量回归分析确定了复发的独立预后因素。

结果

年发病率为每10万人中6.8例。10年累积复发率为0.44（95%置信区间，0.37 - 0.53）。复发的独立预后因素为：年龄低于15岁（风险比 = 2.2；p>z = 0.002），胆脂瘤局限于乳突（风险比 = 1.7；p>z = 0.04），镫骨侵蚀（风险比 = 1.9；p>z = 0.02）和砧骨侵蚀（风险比 = 1.9；p>z = 0.04）。