与鼻窦鳞状细胞癌一期手术治疗方法相关的因素。
Factors associated with a primary surgical approach for sinonasal squamous cell carcinoma.
作者信息
Cracchiolo Jennifer R, Patel Krupa, Migliacci Jocelyn C, Morris Luc T, Ganly Ian, Roman Benjamin R, McBride Sean M, Tabar Viviane S, Cohen Marc A
机构信息
Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Weill Cornell Medical College, New York, New York.
出版信息
J Surg Oncol. 2018 Mar;117(4):756-764. doi: 10.1002/jso.24923. Epub 2017 Nov 28.
BACKGROUND AND OBJECTIVES
Primary surgery is the preferred treatment of T1-T4a sinonasal squamous cell carcinoma (SNSCC).
METHODS
Patients with SNSCC in the National Cancer Data Base (NCDB) were analyzed. Factors that contributed to selecting primary surgical treatment were examined. Overall survival (OS) in surgical patients was analyzed.
RESULTS
Four-thousand seven hundred and seventy patients with SNSCC were included. In T1-T4a tumors, lymph node metastases, maxillary sinus location, and treatment at high-volume centers were associated with selecting primary surgery. When primary surgery was utilized, tumor factors and positive margin guided worse OS. Adjuvant therapy improved OS in positive margin resection and advanced T stage cases.
CONCLUSIONS
Tumor and non-tumor factors are associated with selecting surgery for the treatment of SNSCC. When surgery is selected, tumor factors drive OS. Negative margin resection should be the goal of a primary surgical approach. When a positive margin resection ensues, adjuvant therapy may improve OS.
背景与目的
原发手术是T1-T4a期鼻窦鳞状细胞癌（SNSCC）的首选治疗方法。
方法
对国家癌症数据库（NCDB）中的SNSCC患者进行分析。研究有助于选择原发手术治疗的因素。分析手术患者的总生存期（OS）。
结果
纳入4770例SNSCC患者。在T1-T4a期肿瘤中，淋巴结转移、上颌窦位置以及在大型中心接受治疗与选择原发手术相关。采用原发手术时，肿瘤因素和切缘阳性提示总生存期较差。辅助治疗可改善切缘阳性切除和晚期T分期病例的总生存期。
结论
肿瘤和非肿瘤因素与选择手术治疗SNSCC相关。选择手术时，肿瘤因素决定总生存期。阴性切缘切除应是原发手术方法的目标。当切缘阳性切除后，辅助治疗可能改善总生存期。
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