口咽鳞状细胞癌的生存情况受解剖亚部位影响：美国国家癌症数据库研究
Anatomical subsite modifies survival in oropharyngeal squamous cell carcinoma: National Cancer Database study.
作者信息
Tham Tristan, Ahn Seungjun, Frank Douglas, Kraus Dennis, Costantino Peter
机构信息
Department of Otolaryngology - Head and Neck Surgery, Zucker School of Medicine at Hofstra/Northwell, New York, New York.
Department of Biostatistics, Feinstein Institute of Medical Research, Manhasset, New York.
出版信息
Head Neck. 2020 Mar;42(3):434-445. doi: 10.1002/hed.26019. Epub 2019 Nov 27.
BACKGROUND
Oropharyngeal squamous cell carcinomas (OPSCC) can occur in either tonsillar related areas (TRA) or nontonsillar areas (nTRA). The prognostic differences between these sites are unclear. This study investigated this question using the National Cancer Database (NCDB), controlling for other confounders including human papillomavirus (HPV) status.
METHODS
This NCDB study was conducted by stratifying the HPV-positive oropharyngeal cancer cohort into two primary groups, TRA and nTRA. Kaplan Meier survival analysis was stratified according to HPV status, and further analysis was conducted using multivariable Cox regression.
RESULTS
A total of 23 297 patients were included in this study. In the multivariable cox regression analysis, OPSCC subsite was found to be an independent prognostic factor for survival (TRA vs nTRA HR: 0.76, 95% CI: 0.67-0.86, P < .0001).
CONCLUSION
In this large cohort, OPSCC subsite was found to be an independent prognostic factor for survival.
背景
口咽鳞状细胞癌（OPSCC）可发生于扁桃体相关区域（TRA）或非扁桃体区域（nTRA）。这些部位之间的预后差异尚不清楚。本研究利用国家癌症数据库（NCDB）对这一问题进行了调查，并对包括人乳头瘤病毒（HPV）状态在内的其他混杂因素进行了控制。
方法
本NCDB研究通过将HPV阳性口咽癌队列分为两个主要组，即TRA和nTRA来进行。Kaplan Meier生存分析根据HPV状态进行分层，并使用多变量Cox回归进行进一步分析。
结果
本研究共纳入23297例患者。在多变量Cox回归分析中，发现OPSCC亚部位是生存的独立预后因素（TRA与nTRA相比，HR：0.76，95%CI：0.67-0.86，P<0.0001）。
结论
在这个大型队列中，发现OPSCC亚部位是生存的独立预后因素。
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