头颈部皮肤鳞状细胞癌的区域转移：关于结外扩展和软组织转移意义的最新进展

Regional Metastasis in Head and Neck Cutaneous Squamous Cell Carcinoma: An Update on the Significance of Extra-Nodal Extension and Soft Tissue Metastasis.

作者信息

Hasmat Shaheen, Mooney Craig, Gao Kan, Palme Carsten E, Ebrahimi Ardalan, Ch'ng Sydney, Gupta Ruta, Low Tsu-Hui, Clark Jonathan

机构信息

Sydney Head and Neck Cancer Institute, The Chris O'Brien Lifehouse, Camperdown, NSW, Australia.

Central Clinical School, University of Sydney, Sydney, NSW, Australia.

出版信息

Ann Surg Oncol. 2020 Aug;27(8):2840-2845. doi: 10.1245/s10434-020-08252-9. Epub 2020 Feb 18.

DOI:10.1245/s10434-020-08252-9

PMID:32072378

Abstract

BACKGROUND

Soft tissue metastases (STMs) are reported to predict worse prognosis than extra-nodal extension (ENE) in metastatic head and neck cutaneous squamous cell carcinoma. This study aimed to update the authors' previous analysis of STM in a larger series.

METHODS

The study analyzed 535 cases of consecutive cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007. A Cox proportional hazard model was used to determine the effect of STM, with adjustment for other relevant prognostic factors. Overall survival (OS) and disease-specific survival (DSS) were the primary end points.

RESULTS

Of the 535 patients, 275 (51.4%) had STM. After adjustment for the effects of age, tumor location, number of metastatic deposits, and adjuvant radiotherapy, both STM (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.08-2.22; p = 0.018) and ENE (HR, 1.56; 95% CI 1.10-2.22; p = 0.013) were shown to be independent predictors of reduced OS, with similar size of effect.

CONCLUSION

In metastatic cSCC of the head and neck, STM is an independent predictor of reduced survival and has an impact on survival similar to that of ENE.

摘要

背景

据报道，在转移性头颈部皮肤鳞状细胞癌中，软组织转移（STM）比结外扩展（ENE）预后更差。本研究旨在更新作者之前对更大系列STM的分析。

方法

该研究分析了1987年至2007年间连续535例接受原发手术切除的腮腺和/或颈部转移性皮肤鳞状细胞癌（cSCC）病例。使用Cox比例风险模型确定STM的影响，并对其他相关预后因素进行调整。总生存期（OS）和疾病特异性生存期（DSS）是主要终点。

结果

535例患者中，275例（51.4%）有STM。在调整年龄、肿瘤位置、转移灶数量和辅助放疗的影响后，STM（风险比[HR]，1.55；95%置信区间[CI]，1.08 - 2.22；p = 0.018）和ENE（HR，1.56；95% CI 1.10 - 2.22；p = 0.013）均被证明是OS降低的独立预测因素，影响大小相似。