HPV 相关局部晚期口咽癌中影像学定义的结外侵犯的预后价值。
Prognostic value of radiographically defined extranodal extension in human papillomavirus-associated locally advanced oropharyngeal carcinoma.
机构信息
Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia.
Rollins School of Public Health, Emory University, Atlanta, Georgia.
出版信息
Head Neck. 2019 Sep;41(9):3056-3063. doi: 10.1002/hed.25791. Epub 2019 May 2.
BACKGROUND
Pathologic extranodal extension (ENE) has traditionally guided the management of head and neck cancers. The prognostic value of radiographic ENE (rENE) in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (HPV + OPX) is uncertain.
METHODS
Patients with HPV + OPX with adequate pretreatment radiographic nodal evaluation from a single institution were analyzed. rENE status was determined by neuroradiologists' at time of diagnosis. Distant metastasis-free survival (DMFS), overall survival (OS), and locoregional recurrence-free survival (LRFS) were estimated using Kaplan-Meier methods. Cox proportional hazards models were fit to assess the impact of rENE on survival endpoints.
RESULTS
Hundred sixty-eight patients with OPX + squamous cell carcinomas diagnosed between April 2008 and December 2014 were included for analysis with median follow-up of 3.3 years. Eighty-eight percent of patients received concurrent chemoradiotherapy. rENE was not prognostic; its presence in patients with HPV + OPX did not significantly impact OS, LRFS, or DMFS.
CONCLUSIONS
In patients with HPV + OPX, rENE was not significantly associated with OS, LRFS, or DMFS.
背景
病理性结外扩展（ENE）传统上指导头颈部癌症的治疗。人乳头瘤病毒（HPV）相关口咽鳞状细胞癌（HPV+OPX）中放射性 ENE（rENE）的预后价值尚不确定。
方法
分析了来自单一机构的 HPV+OPX 患者，这些患者具有充分的预处理放射性淋巴结评估。rENE 状态由神经放射科医生在诊断时确定。通过 Kaplan-Meier 方法估计无远处转移生存率（DMFS）、总生存率（OS）和局部区域无复发生存率（LRFS）。使用 Cox 比例风险模型评估 rENE 对生存终点的影响。
结果
纳入了 168 例 2008 年 4 月至 2014 年 12 月诊断的 OPX+鳞状细胞癌患者进行分析，中位随访时间为 3.3 年。88%的患者接受了同期放化疗。rENE 没有预后意义；其存在于 HPV+OPX 患者中与 OS、LRFS 或 DMFS 无显著相关性。
结论
在 HPV+OPX 患者中，rENE 与 OS、LRFS 或 DMFS 无显著相关性。
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