酒精和烟草消费可预测头颈癌患者的死亡率：国际头颈癌流行病学（INHANCE）联盟的汇总分析。
Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium.
作者信息
Giraldi L, Leoncini E, Pastorino R, Wünsch-Filho V, de Carvalho M, Lopez R, Cadoni G, Arzani D, Petrelli L, Matsuo K, Bosetti C, La Vecchia C, Garavello W, Polesel J, Serraino D, Simonato L, Canova C, Richiardi L, Boffetta P, Hashibe M, Lee Y C A, Boccia S
机构信息
Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
出版信息
Ann Oncol. 2017 Nov 1;28(11):2843-2851. doi: 10.1093/annonc/mdx486.
BACKGROUND
This study evaluated whether demographics, pre-diagnosis lifestyle habits and clinical data are associated with the overall survival (OS) and head and neck cancer (HNC)-specific survival in patients with HNC.
PATIENTS AND METHODS
We conducted a pooled analysis, including 4759 HNC patients from five studies within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. Cox proportional hazard ratios (HRs) and the corresponding 95% confidence intervals (CIs) were estimated including terms reported significantly associated with the survival in the univariate analysis.
RESULTS
Five-year OS was 51.4% for all HNC sites combined: 50.3% for oral cavity, 41.1% for oropharynx, 35.0% for hypopharynx and 63.9% for larynx. When we considered HNC-specific survival, 5-year survival rates were 57.4% for all HNC combined: 54.6% for oral cavity, 45.4% for oropharynx, 37.1% for hypopharynx and 72.3% for larynx. Older ages at diagnosis and advanced tumour staging were unfavourable predictors of OS and HNC-specific survival. In laryngeal cancer, low educational level was an unfavourable prognostic factor for OS (HR = 2.54, 95% CI 1.01-6.38, for high school or lower versus college graduate), and status and intensity of alcohol drinking were prognostic factors both of the OS (current drinkers HR = 1.73, 95% CI 1.16-2.58) and HNC-specific survival (current drinkers HR = 2.11, 95% CI 1.22-3.66). In oropharyngeal cancer, smoking status was an independent prognostic factors for OS. Smoking intensity (>20 cigarettes/day HR = 1.41, 95% CI 1.03-1.92) was also an independent prognostic factor for OS in patients with cancer of the oral cavity.
CONCLUSIONS
OS and HNC-specific survival differ among HNC sites. Pre-diagnosis cigarette smoking is a prognostic factor of the OS for patients with cancer of the oral cavity and oropharynx, whereas pre-diagnosis alcohol drinking is a prognostic factor of OS and HNC-specific survival for patients with cancer of the larynx. Low educational level is an unfavourable prognostic factor for OS in laryngeal cancer patients.
背景
本研究评估了人口统计学特征、诊断前生活习惯和临床数据是否与头颈癌（HNC）患者的总生存期（OS）及头颈癌特异性生存期相关。
患者与方法
我们进行了一项汇总分析，纳入了国际头颈癌流行病学（INHANCE）联盟五项研究中的4759例HNC患者。估计了Cox比例风险比（HRs）及相应的95%置信区间（CIs），纳入了单变量分析中报告的与生存期显著相关的因素。
结果
所有HNC部位合并后的5年总生存率为51.4%：口腔癌为50.3%，口咽癌为41.1%，下咽癌为35.0%，喉癌为63.9%。当考虑头颈癌特异性生存期时，所有HNC合并后的5年生存率为57.4%：口腔癌为54.6%，口咽癌为45.4%，下咽癌为37.1%，喉癌为72.3%。诊断时年龄较大和肿瘤分期较晚是总生存期及头颈癌特异性生存期的不利预测因素。在喉癌中，低教育水平是总生存期的不利预后因素（对于高中及以下学历与大学学历者，HR = 2.54，95% CI 1.01 - 6.38），饮酒状态和饮酒强度是总生存期（当前饮酒者HR = 1.73，95% CI 1.16 - 2.58）及头颈癌特异性生存期（当前饮酒者HR = 2.11，95% CI 1.22 - 3.66）的预后因素。在口咽癌中，吸烟状态是总生存期的独立预后因素。吸烟强度（>20支/天，HR = 1.41，95% CI 1.03 - 1.92）也是口腔癌患者总生存期的独立预后因素。
结论
头颈癌各部位的总生存期及头颈癌特异性生存期存在差异。诊断前吸烟是口腔癌和口咽癌患者总生存期的预后因素，而诊断前饮酒是喉癌患者总生存期及头颈癌特异性生存期的预后因素。低教育水平是喉癌患者总生存期的不利预后因素。
Zotero 插件