Masoudi Sahar, Montazeri Seyed Ali, Pourdanesh Fereydoun, Biglarian Akbar, Kazemi Masoud, Rahgozar Mehdi
Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Student of Public Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2017 Aug;20(8):503-510.
Squamous cell carcinoma is the most common histological subtype of head and neck cancers.
In a retrospective longitudinal study, we assessed the risk of local or metastatic recurrence and death in 140 patients with head and neck squamous cell carcinoma (HNSCC). Multivariate and shared frailty models were used for survival analysis with sex, primary tumor site, grade and stage of the tumor, and treatment modalities as contributing factors.
The most frequent site for HNSCC was the oral cavity (30%), followed by the tongue (26.4%). For most primary sites, men were at nearly 2-fold higher risk of local recurrence than women, but there was no difference by sex in the risk of metastatic recurrence. Undifferentiated HNSCC was associated with a higher risk of local recurrence (nearly 4-fold) and metastasis (6-15-fold based on the primary site) than well-differentiated tumors. In early months after surgical resection alone, the risk of local recurrence was higher compared to other treatment modalities. There was a strong dependency between the risk of local and metastatic recurrence.
In conclusion, men diagnosed with HNSCC, those with higher grade or advanced state tumor, and those treated by surgery alone are at higher risk of unfavorable outcomes than others and may need more frequent follow-up visits.
鳞状细胞癌是头颈部癌症最常见的组织学亚型。
在一项回顾性纵向研究中，我们评估了140名头颈部鳞状细胞癌（HNSCC）患者局部或远处复发及死亡的风险。采用多变量和共享脆弱模型进行生存分析，将性别、原发肿瘤部位、肿瘤分级和分期以及治疗方式作为影响因素。
HNSCC最常见的部位是口腔（30%），其次是舌部（26.4%）。对于大多数原发部位，男性局部复发的风险几乎是女性的2倍，但远处复发风险在性别上无差异。与高分化肿瘤相比，未分化HNSCC局部复发风险更高（近4倍），转移风险更高（根据原发部位为6 - 15倍）。仅在手术切除后的早期几个月，局部复发风险高于其他治疗方式。局部和远处复发风险之间存在很强的相关性。
总之，诊断为HNSCC的男性、肿瘤分级较高或处于晚期的患者以及仅接受手术治疗的患者，比其他患者出现不良结局的风险更高，可能需要更频繁的随访。
