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肿瘤范围在头颈部腺鳞癌中的重要性:一项回顾性队列研究。

Importance of tumor extent in adenosquamous carcinoma of the head and neck: a retrospective cohort study.

作者信息

Lee Robert J, Lin Thomas, Lee Serena A, Lee Kevin K, Christensen Russell E

机构信息

Orthodontic resident, Division of Orthodontics, UCSF School of Dentistry, San Francisco, CA, USA.

Private practice, Alhambra, CA, USA.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Aug;124(2):114-120. doi: 10.1016/j.oooo.2017.03.004. Epub 2017 Mar 10.

Abstract

OBJECTIVE

The aim of this study was to determine the correlates of survival for patients diagnosed with adenosquamous carcinoma (ASC) of the head and neck.

STUDY DESIGN

Patients diagnosed with ASC of the head and neck between 1973 and 2012 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier and Cox proportional hazard regression analyses were conducted to investigate the prognostic factors and treatment modalities that determine overall survival (OS) and disease-specific survival (DSS).

RESULTS

In the analysis, of the 235 patients diagnosed with adenosquamous of the head and neck, 66.8% were male and 33.2% were female with a median age at diagnosis of 64 years. Kaplan-Meier analysis determined 5-year survival rates of 30% for OS and 50% for DSS. Univariate and multivariate analyses found that age at diagnosis, tumor size, tumor extent of disease, surgical resection, and radiation therapy were independent predictors of OS and DSS.

CONCLUSIONS

This study, to our knowledge, is the largest study, to date, determining the correlates of survival for ASC of the head and neck. Older age at diagnosis, larger tumor size, and further extent of disease were correlated with decreased survival. Surgical resection improves survival in patients with localized or regional disease, whereas radiation therapy confers survival benefit in patients with distant extent.

摘要

目的

本研究旨在确定头颈部腺鳞癌(ASC)患者生存的相关因素。

研究设计

从监测、流行病学和最终结果(SEER)数据库中识别出1973年至2012年间被诊断为头颈部ASC的患者。进行了Kaplan-Meier和Cox比例风险回归分析,以研究决定总生存期(OS)和疾病特异性生存期(DSS)的预后因素和治疗方式。

结果

在分析中,235例被诊断为头颈部腺鳞癌的患者中,66.8%为男性,33.2%为女性,诊断时的中位年龄为64岁。Kaplan-Meier分析确定OS的5年生存率为30%,DSS为50%。单因素和多因素分析发现,诊断时的年龄、肿瘤大小、疾病的肿瘤范围、手术切除和放射治疗是OS和DSS的独立预测因素。

结论

据我们所知,本研究是迄今为止确定头颈部ASC生存相关因素的最大规模研究。诊断时年龄较大、肿瘤较大以及疾病范围较广与生存率降低相关。手术切除可提高局限性或区域性疾病患者的生存率,而放射治疗可使远处转移患者获得生存益处。

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