Department of Otolaryngology - Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Community Oral Health Department, Dental School, University of Glasgow, Glasgow, UK.
Clin Otolaryngol. 2018 Jun;43(3):795-804. doi: 10.1111/coa.13053. Epub 2018 Jan 15.
To assess how type and number of symptoms are related to survival in patients with head and neck cancer.
Patients were followed up for over 10 years from the Scottish Audit of Head and Neck Cancer (national cohort of head and neck cancer patients in Scotland 1999-2001). September 2013, cohort was linked to national mortality data. First, second and third presenting symptoms were recorded at diagnosis.
National prospective audit-Scotland.
A subset of 1589 patients, from the original cohort of 1895, who had cancer arising from one of the four main subsites; larynx, oropharynx, oral cavity and hypopharynx.
Median survival in relation to patients' presenting symptoms.
A total of 1146 (72%) males and 443 (28%) females, mean age at diagnosis 64 years (13-95). There was a significant difference in survival in relation to the number of the patient's presenting symptoms; one symptom had a median survival of 5.3 years compared with 1.1 years for three symptoms. Patients who presented with weight loss had a median survival of 0.8 years, compared to 4.2 years if they did not (P < .001). Patients who presented with hoarseness had a median survival of 5.9 years compared to 2.6 years without (P < .001). There was no significant difference in long-term survival for patients who presented with an ulcer, compared to those that did not (P = .105).
This study highlights the importance of patients' presenting symptoms, giving valuable information in highlighting appropriate "red flag" symptoms and subsequent treatment planning and prognosis.
评估头颈部癌症患者的症状类型和数量与生存的关系。
对来自苏格兰头颈部癌症审计（1999-2001 年苏格兰头颈部癌症患者的全国队列）的患者进行了超过 10 年的随访。2013 年 9 月，该队列与国家死亡率数据相关联。在诊断时记录了首发症状、第二症状和第三症状。
苏格兰国家前瞻性审计。
来自最初队列的 1895 名患者中的一个亚组，他们患有源自四个主要亚部位之一的癌症；喉、口咽、口腔和下咽。
与患者首发症状相关的中位生存时间。
共有 1146 名男性（72%）和 443 名女性（28%），诊断时的平均年龄为 64 岁（13-95 岁）。与患者首发症状的数量存在显著差异；有一个症状的中位生存期为 5.3 年，而有三个症状的中位生存期为 1.1 年。出现体重减轻的患者中位生存期为 0.8 年，而没有体重减轻的患者为 4.2 年（P < 0.001）。出现声音嘶哑的患者中位生存期为 5.9 年，而没有声音嘶哑的患者为 2.6 年（P < 0.001）。出现溃疡的患者与没有出现溃疡的患者相比，长期生存没有显著差异（P = 0.105）。
本研究强调了患者首发症状的重要性，为突出适当的“危险信号”症状以及随后的治疗计划和预后提供了有价值的信息。
