1 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Saint Louis University, Saint Louis, Missouri, USA.
Otolaryngol Head Neck Surg. 2019 May;160(5):847-854. doi: 10.1177/0194599818816299. Epub 2019 Feb 5.
Basaloid squamous cell histology is a rare variant that accounts for about 2% of all head and neck squamous cell laryngeal carcinomas. The purpose of this study was to examine overall survival rates of patients according to treatment, stage, and laryngeal subsite.
Retrospective analysis.
National Cancer Database (NCDB).
The NCDB was queried for patients with basaloid squamous cell carcinoma (BSCC) who were treated from 2004 to 2014. Five-year overall survival rates were determined by the Kaplan-Meier method. Univariate and multivariate analysis was used to identify factors correlated with 5-year overall survival.
The NCDB identified 440 patients meeting inclusion criteria. Median follow-up time was 31.2 months. On univariate analysis, the treatment modalities assessed (surgery alone, surgery with radiotherapy, surgery with chemoradiotherapy, radiotherapy, chemoradiotherapy) did not differ in their survival benefit. On multivariate analysis, only chemoradiotherapy (hazard ratio, 0.587; 95% CI, 0.37-0.93; P = .022) was associated with improved survival. All treatment modalities performed similarly between stage I and II tumors ( P = .340) and stage III and IV tumors ( P = .154).
This study represents the largest laryngeal BSCC series to date. We found that chemoradiotherapy was associated with improved 5-year overall survival of laryngeal BSCC on multivariate analysis.
基底样鳞状细胞组织学是一种罕见的变异型,约占所有头颈部鳞状细胞喉癌的 2%。本研究旨在根据治疗、分期和喉亚部位检查患者的总生存率。
回顾性分析。
国家癌症数据库(NCDB)。
NCDB 被查询用于治疗 2004 年至 2014 年期间患有基底样鳞状细胞癌(BSCC)的患者。通过 Kaplan-Meier 方法确定 5 年总生存率。使用单因素和多因素分析来确定与 5 年总生存率相关的因素。
NCDB 确定了 440 名符合纳入标准的患者。中位随访时间为 31.2 个月。在单因素分析中,评估的治疗方式(单独手术、手术加放疗、手术加放化疗、放疗、放化疗)在生存获益方面没有差异。在多因素分析中,只有放化疗(风险比,0.587;95%CI,0.37-0.93;P =.022)与生存改善相关。所有治疗方式在 I 期和 II 期肿瘤(P =.340)和 III 期和 IV 期肿瘤(P =.154)之间的表现相似。
本研究是迄今为止最大的喉部 BSCC 系列研究。我们发现,多因素分析显示放化疗与改善喉部 BSCC 的 5 年总生存率相关。