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贫血和 BMI 对喉鳞状细胞癌预后的影响:预后模型的更新。

Influence of anemia and BMI on prognosis of laryngeal squamous cell carcinoma: Development of an updated prognostic model.

机构信息

Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, The Netherlands.

Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, The Netherlands.

出版信息

Oral Oncol. 2018 Mar;78:25-30. doi: 10.1016/j.oraloncology.2018.01.001. Epub 2018 Jan 11.

Abstract

OBJECTIVE

evaluating the impact of anemia and body mass index (BMI) on survival, and development of a prognostic model for overall survival for patients with laryngeal squamous cell carcinoma (LSCC).

MATERIALS AND METHODS

A retrospective cohort study was performed including all consecutive patients with LSCC diagnosed and treated at the Erasmus Medical Center between January 2006 and December 2013. Patient- and tumor-specific data were collected using data from the Netherlands Comprehensive Cancer Organization and supplemented with data from patient records available in the Erasmus MC. All comorbidities were scored at the time of diagnosis.

RESULTS

in total 788 patients were included. Mean follow-up time was 50 months (SD: ±30), during which 298 patients (37.8%) died. In both univariate and multivariate analysis BMI and anemia were significant predictors for overall survival. Multivariate analysis was performed using known predictors such as age, TNM-stage and comorbidity (ACE-27). The hazard ratio of anemia was 1.41 (95% CI: 1.05-1.90) and of BMI was 0.97 (95% CI: 0.94-0.99). BMI had an inverse association with overall survival in both univariate and multivariate survival analysis. Updating and validating an existing prognostic model with addition of anemia and BMI enhanced the performance of the prognostic model (C-statistic) from 0.77 (95% CI: 0.74-0.79) to 0.79 (95% CI: 0.77-0.82).

CONCLUSION

anemia and BMI are predictors of overall survival for LSCC, independent of other known predictors of overall survival. Adding anemia and BMI to an existing prognostic model provides better prediction of overall survival.

摘要

目的

评估贫血和体重指数(BMI)对生存的影响,并为喉鳞状细胞癌(LSCC)患者的总生存建立一个预后模型。

材料和方法

这是一项回顾性队列研究,纳入了 2006 年 1 月至 2013 年 12 月期间在伊拉斯姆斯医疗中心诊断和治疗的所有连续 LSCC 患者。使用荷兰综合癌症组织的数据以及从伊拉斯姆斯 MC 可用的患者记录中补充的数据收集患者和肿瘤特异性数据。所有合并症均在诊断时进行评分。

结果

共纳入 788 例患者。中位随访时间为 50 个月(标准差:±30),期间 298 例(37.8%)患者死亡。单变量和多变量分析均显示 BMI 和贫血是总生存的显著预测因素。多变量分析使用已知的预测因素,如年龄、TNM 分期和合并症(ACE-27)。贫血的风险比为 1.41(95%可信区间:1.05-1.90),BMI 为 0.97(95%可信区间:0.94-0.99)。BMI 在单变量和多变量生存分析中与总生存均呈负相关。在添加贫血和 BMI 的情况下更新和验证现有的预后模型,提高了预后模型(C 统计量)的性能,从 0.77(95%可信区间:0.74-0.79)提高到 0.79(95%可信区间:0.77-0.82)。

结论

贫血和 BMI 是 LSCC 总生存的独立预测因素,独立于其他已知的总生存预测因素。将贫血和 BMI 添加到现有的预后模型中,可以更好地预测总生存。

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