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头颈部横纹肌肉瘤:人口统计学和临床病理因素对生存的影响。

Rhabdomyosarcoma of the head and neck: impact of demographic and clinicopathologic factors on survival.

作者信息

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

机构信息

Orthodontic resident, Division of Orthodontics, UCSF School of Dentistry, 707 Parnassus Ave., San Francisco, CA, USA.

Dental student, University of California, Los Angeles School of Dentistry, Los Angeles, CA, USA.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Sep;124(3):271-279. doi: 10.1016/j.oooo.2017.05.507. Epub 2017 May 30.

Abstract

OBJECTIVE

To determine the survival factors for patients diagnosed with rhabdomyosarcoma of the head and neck.

STUDY DESIGN

Data on patients diagnosed with rhabdomyosarcoma of the head and neck between 1973 and 2012 were extracted from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier and Cox proportional hazard regression models were used to determine the demographic characteristics, prognostic factors, and treatment modalities that determine overall survival (OS) and disease-specific survival (DSS).

RESULTS

Data on 503 patients diagnosed with rhabdomyosarcoma of the head and neck were analyzed; 51.3% were male and 48.7% were female, with a median OS of 4.9 years. Kaplan-Meier analysis determined 5-year survival rates of 30% for OS and 50% for DSS. Multivariate analysis found that age at diagnosis, tumor extent of disease, surgical resection, and radiation therapy were independent predictors of OS and DSS.

CONCLUSIONS

To our knowledge, this is the largest year-span study to date to determine the factors of survival for rhabdomyosarcoma of the head and neck. Older age at diagnosis, histologic subtype of alveolar rhabdomyosarcoma, and further extent of disease were associated with decreased survival. Surgical resection improves survival in patients with localized or regional disease, and radiation therapy confers survival benefits in patients with distant extent.

摘要

目的

确定头颈部横纹肌肉瘤患者的生存因素。

研究设计

从监测、流行病学和最终结果数据库中提取1973年至2012年间被诊断为头颈部横纹肌肉瘤患者的数据。采用Kaplan-Meier法和Cox比例风险回归模型来确定决定总生存期(OS)和疾病特异性生存期(DSS)的人口统计学特征、预后因素及治疗方式。

结果

对503名头颈部横纹肌肉瘤患者的数据进行了分析;其中男性占51.3%,女性占48.7%,中位总生存期为4.9年。Kaplan-Meier分析确定总生存期的5年生存率为30%,疾病特异性生存期的5年生存率为50%。多变量分析发现,诊断时的年龄、疾病的肿瘤范围、手术切除和放射治疗是总生存期和疾病特异性生存期的独立预测因素。

结论

据我们所知,这是迄今为止跨度最大的一项确定头颈部横纹肌肉瘤生存因素的研究。诊断时年龄较大、腺泡状横纹肌肉瘤的组织学亚型以及疾病范围进一步扩大与生存率降低相关。手术切除可提高局限性或区域性疾病患者的生存率,放射治疗对远处转移的患者有生存益处。

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