Ye Lu-Lu, Rao Jia, Fan Xing-Wen, Ji Qing-Hai, Hu Chao-Su, Ying Hong-Mei
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China,
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China,
Cancer Manag Res. 2018 Oct 10;10:4679-4688. doi: 10.2147/CMAR.S178750. eCollection 2018.
To analyze the potential variables affecting the survival of patients undergoing primary surgery for hypopharyngeal squamous cell carcinoma.
Between August 2007 and December 2016, 93 patients with primary hypopharyngeal squamous cell carcinomas undergoing radical surgery at Fudan University Shanghai Cancer Center were reviewed. The clinicopathological features were analyzed retrospectively. The optimal cutoff values were determined based on the receiver operating characteristic curve analysis. Pearson correlation coefficients were used to assess the correlations between variables. The Kaplan-Meier and Cox proportional hazard methods were used to evaluate the impact of variables on overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS).
Cox multivariate analysis revealed that a depth of invasion (DOI) ≥ 4.3 mm was correlated with inferior OS (=0.045), DSS (=0.046), and DFS (=0.046). A primary tumor volume (PTV) ≥0.36 mL was related to poor OS (=0.018), DSS (=0.026), and DFS (=0.036). A lymph node density (LND) ≥0.07 was also associated with worse OS (=0.014) and DSS (=0.045). Moreover, additional prognostic value was observed in the combined use of PTV and LND.
The DOI, PTV, and LND obtained from the surgical specimens could provide additional valuable information for prognostic stratification and allowed the more appropriate selection of suitable candidates for more aggressive adjuvant therapy.
分析影响下咽鳞状细胞癌初次手术患者生存的潜在变量。
回顾性分析2007年8月至2016年12月在复旦大学附属肿瘤医院接受根治性手术的93例原发性下咽鳞状细胞癌患者。回顾性分析临床病理特征。基于受试者工作特征曲线分析确定最佳截断值。采用Pearson相关系数评估变量之间的相关性。采用Kaplan-Meier法和Cox比例风险法评估变量对总生存（OS）、疾病特异性生存（DSS）和无病生存（DFS）的影响。
Cox多因素分析显示，浸润深度（DOI）≥4.3mm与较差的OS（P=0.045）、DSS（P=0.046）和DFS（P=0.046）相关。原发肿瘤体积（PTV）≥0.36mL与较差的OS（P=0.018）、DSS（P=0.026）和DFS（P=0.036）相关。淋巴结密度（LND）≥0.07也与较差的OS（P=0.014）和DSS（P=0.045）相关。此外，联合使用PTV和LND具有额外的预后价值。
手术标本获取的DOI、PTV和LND可为预后分层提供额外有价值的信息，并有助于更合适地选择适合接受更积极辅助治疗的患者。
