Nachalon Yuval, Alkan Uri, Shvero Jacob, Yaniv Dan, Shkedy Yotam, Limon Dror, Popovtzer Aron
Department of Otorhinolaryngology-Head and Neck Surgery.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Laryngoscope. 2018 Jul;128(7):1602-1605. doi: 10.1002/lary.26951. Epub 2017 Oct 27.
OBJECTIVES/HYPOTHESIS: To assess the differences between patients with laryngeal squamous cell carcinoma under 40 years old and those 40 years old or older. A secondary objective was to compare survival outcome between these cohorts.
Retrospective chart review.
We reviewed the medical charts of all patients treated in our tertiary referral center for laryngeal squamous cell carcinoma from 2005 to 2014. Patients aged < 40 years at diagnosis were compared to older patients.
The study group comprised 160 patients. Of them, 13 were aged < 40 years at diagnosis. Mean age was 35 ± 3.9 years and 64.4 ± 11 years for the two groups. Among the younger patients, 38% were smokers (mean pack/day, 2.2) versus 71% in the older group (mean pack/day, 3). The younger group typically had a more advanced stage than the older group at presentation; eight young patients (62%) had stage III or IV versus 49 (33%) in the older group (P = .042). Mean overall survival was 6.7 ± 1 years for those under 40 years old and 7.7 ± 0.2 years for the older patients (P = .2). The 5-year survival rate was 69% for young patients and 90% for the older group (P = .04). However, there was no significant between-group difference in overall survival or 5-year survival rate when stratified for early- and late-stage disease.
There is a lower prevalence of classic risk factors in younger patient with laryngeal carcinoma in this study, suggesting a different etiology compared to our older cohort. The under-40 cohort presented with more advanced disease and had a worse 5-year survival; however, when stratified for early- versus late-stage disease, there was no significant difference in overall or 5-year survival between the groups. This may suggest that, despite a different etiology, laryngeal cancer behaves similarly in older and younger patients.
目的/假设：评估40岁以下喉鳞状细胞癌患者与40岁及以上患者之间的差异。次要目的是比较这些队列之间的生存结果。
回顾性病历审查。
我们回顾了2005年至2014年在我们的三级转诊中心接受治疗的所有喉鳞状细胞癌患者的病历。将诊断时年龄＜40岁的患者与年龄较大的患者进行比较。
研究组包括160名患者。其中，13名患者诊断时年龄＜40岁。两组的平均年龄分别为35±3.9岁和64.4±11岁。在较年轻的患者中，38%为吸烟者（平均每天吸烟量，2.2包），而在年龄较大的组中这一比例为71%（平均每天吸烟量，3包）。较年轻的组在就诊时通常比年龄较大的组处于更晚期阶段；8名年轻患者（62%）处于III期或IV期，而年龄较大的组中有49名（33%）处于该阶段（P = 0.042）。40岁以下患者的平均总生存期为6.7±1年，年龄较大患者为7.7±0.2年（P = 0.2）。年轻患者的5年生存率为69%，年龄较大组为90%（P = 0.04）。然而，按早期和晚期疾病分层时，两组之间在总生存期或5年生存率方面没有显著差异。
在本研究中，较年轻的喉癌患者中经典危险因素的患病率较低，这表明与年龄较大的队列相比病因不同。40岁以下的队列呈现出更晚期的疾病且5年生存率较差；然而，按早期与晚期疾病分层时，两组之间在总生存期或5年生存率方面没有显著差异。这可能表明，尽管病因不同，但喉癌在老年和年轻患者中的表现相似。
4。《喉镜》，128:1602 - 1605，2018年。
