N3期头颈部鳞状细胞癌患者的临床结局：美国国立癌症数据库分析
Clinical outcomes for patients presenting with N3 head and neck squamous cell carcinoma: Analysis of the National Cancer Database.
作者信息
Ko Huaising C, Chen Shuai, Wieland Aaron M, Yu Menggang, Baschnagel Andrew M, Hartig Gregory K, Harari Paul M, Witek Matthew E
机构信息
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
出版信息
Head Neck. 2017 Nov;39(11):2159-2170. doi: 10.1002/hed.24881. Epub 2017 Jul 24.
BACKGROUND
There is a paucity of data regarding head and neck squamous cell carcinomas (HNSCCs) and N3 nodal disease.
METHODS
Retrospective analysis of patients with N3 HNSCC identified in the National Cancer Database (NCDB) was performed.
RESULTS
We identified 4867 patients with N3 HNSCC treated with primary surgery or chemoradiotherapy (CRT). Propensity-adjusted median survival was 54.2 and 44.8 months for surgery and CRT, respectively (P = .06). Oropharyngeal primary subsite demonstrated a survival advantage with surgery versus CRT with propensity-adjusted median survivals of 86.0 and 61.9 months, respectively (P < .05).
CONCLUSION
Management of N3 HNSCC relies largely on CRT. Patients with N3 nodal disease with nonoropharyngeal primary tumors exhibit 5-year overall survival approaching 30% independent of initial treatment modality. Patients with oropharyngeal primaries exhibit improved outcomes with surgery largely influenced by the human papillomavirus (HPV)-negative subset. These data represent the most comprehensive analysis of N3 HNSCC outcomes and serves as a foundation for future research and clinical management.
背景
关于头颈部鳞状细胞癌（HNSCCs）和N3淋巴结疾病的数据匮乏。
方法
对国家癌症数据库（NCDB）中确诊的N3 HNSCC患者进行回顾性分析。
结果
我们确定了4867例接受初次手术或放化疗（CRT）的N3 HNSCC患者。手术组和CRT组倾向调整后的中位生存期分别为54.2个月和44.8个月（P = 0.06）。口咽原发亚部位显示手术组比CRT组有生存优势，倾向调整后的中位生存期分别为86.0个月和61.9个月（P < 0.05）。
结论
N3 HNSCC的治疗很大程度上依赖于CRT。患有N3淋巴结疾病且原发肿瘤不是口咽的患者，无论初始治疗方式如何，其5年总生存率接近30%。口咽原发肿瘤患者手术治疗的效果更好，这在很大程度上受人类乳头瘤病毒（HPV）阴性亚组的影响。这些数据代表了对N3 HNSCC预后最全面的分析，并为未来的研究和临床管理奠定了基础。
Zotero 插件