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头颈癌的预后因素:意大利一家机构的10年回顾性分析

Prognostic factors in head and neck cancer: a 10-year retrospective analysis in a single-institution in Italy.

作者信息

Cadoni G, Giraldi L, Petrelli L, Pandolfini M, Giuliani M, Paludetti G, Pastorino R, Leoncini E, Arzani D, Almadori G, Boccia S

机构信息

Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "Agostino Gemelli", Rome, Italy.

Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):458-466. doi: 10.14639/0392-100X-1246.

Abstract

This study was undertaken to evaluate the association between demographics, lifestyle habits, and clinical data and overall survival (OS), recurrence and second primary cancer (SPC) in patients with first primary head and neck cancer (HNC). We retrospectively reviewed data from 482 patients treated at the "Agostino Gemelli" Teaching Hospital, Rome, between 2002-2012 for primary HNC. Individual parameters were evaluated for association with specific outcomes such as OS, cancer recurrence and second primary cancer (SPC) appearance using hazard ratios (HR) and 95% confidence intervals (CIs). Five-year OS was 60.6% for all HNC cases, 49.0% for oral cavity, 54.8% for oropharynx, 50.0% for hypopharynx and 63.4% for larynx. Predictors of OS were older age (HR = 1.04; 95% CI: 1.02-1.05) and advanced tumour stage (HR = 2.00; 95% CI: 1.41-2.84). The risk of recurrence was associated with drinking 8-14 drinks per week (HR = 1.73; 95% CI: 1.00-2.97). The risk of developing SPC increased with advanced tumour stage (HR = 2.75; 95% CI: 1.39-5.44) and with smoking for more than 40 years (HR = 3.68; 95% CI: 1.10-12.30). OS differed among HNC sites. Increasing age was an unfavourable predictor of HNC OS. Tumour stage was a prognostic factor both for OS and for risk of developing SPC. Alcohol and tobacco consumption were prognostic factors for recurrence and SPC, respectively.

摘要

本研究旨在评估首次原发性头颈癌(HNC)患者的人口统计学、生活习惯、临床数据与总生存期(OS)、复发及第二原发性癌症(SPC)之间的关联。我们回顾性分析了2002年至2012年间在罗马“阿戈斯蒂诺·杰梅利”教学医院接受原发性HNC治疗的482例患者的数据。使用风险比(HR)和95%置信区间(CIs)评估个体参数与特定结局(如OS、癌症复发和SPC出现)之间的关联。所有HNC病例的5年总生存率为60.6%,口腔癌为49.0%,口咽癌为54.8%,下咽癌为50.0%,喉癌为63.4%。总生存期的预测因素为年龄较大(HR = 1.04;95% CI:1.02 - 1.05)和肿瘤晚期(HR = 2.00;95% CI:1.41 - 2.84)。复发风险与每周饮用8 - 14杯酒有关(HR = 1.73;95% CI:1.00 - 2.97)。发生SPC的风险随着肿瘤晚期(HR = 2.75;95% CI:1.39 - 5.44)和吸烟超过40年(HR = 3.68;95% CI:1.10 - 12.30)而增加。HNC各部位的总生存期有所不同。年龄增加是HNC总生存期的不利预测因素。肿瘤分期是总生存期和发生SPC风险的预后因素。饮酒和吸烟分别是复发和SPC的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90d2/5782422/13ae0e575ebf/0392-100X-37-458-g001.jpg

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