患者报告症状在潜在治愈喉癌患者随访中的价值
Value of patient-reported symptoms in the follow up of patients potentially cured of laryngeal carcinoma.
作者信息
Brandstorp-Boesen J, Zätterström U, Evensen J F, Boysen M
机构信息
Department of Oto-Rhino-Laryngology,Head and Neck Surgery,Division of Surgery and Clinical Neuroscience,Oslo University Hospital,Norway.
Section for Head and Neck Cancer,Radiumhospitalet, Oslo University Hospital,Norway.
出版信息
J Laryngol Otol. 2019 Jun;133(6):508-514. doi: 10.1017/S0022215119000677. Epub 2019 Apr 22.
OBJECTIVE
To evaluate the significance of patients' ability to recognise symptoms that signify recurrence.
METHODS
A retrospective analysis was conducted in Norway of demographic, clinical and follow-up data for patients with laryngeal carcinoma considered free of disease following treatment. The study included clinical data from 732 patients with glottic tumours and 249 patients with supraglottic tumours who were considered cured of disease. Data on the site, time and type of recurrence (symptomatic or asymptomatic) were retrieved.
RESULTS
Recurrence was observed in 127 patients with glottic tumours and 71 with supraglottic tumours. A total of 103 glottic recurrences and 53 supraglottic recurrences were symptomatic. For patients with glottic carcinoma, recurrence detection through symptoms was associated with a favourable post-salvage survival rate compared with asymptomatic recurrences (p = 0.003).
CONCLUSION
A patient's ability to self-detect 'red flag' symptoms and self-initiate visits represents a previously ignored prognostic factor, and may rationalise follow up and improve survival.
目的
评估患者识别提示复发症状的能力的重要性。
方法
在挪威对接受治疗后被认为无疾病的喉癌患者的人口统计学、临床和随访数据进行回顾性分析。该研究纳入了732例声门肿瘤患者和249例声门上肿瘤患者的临床数据，这些患者被认为已治愈。检索了复发的部位、时间和类型（有症状或无症状）的数据。
结果
在127例声门肿瘤患者和71例声门上肿瘤患者中观察到复发。共有103例声门复发和53例声门上复发有症状。对于声门癌患者，与无症状复发相比，通过症状检测到复发与挽救治疗后的生存率良好相关（p = 0.003）。
结论
患者自我检测“危险信号”症状并自行就诊的能力是一个以前被忽视的预后因素，可能使随访合理化并提高生存率。
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