Department of Otolaryngology, Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
School of Nursing, Fudan University, Shanghai, China.
Cancer Med. 2020 May;9(9):3006-3014. doi: 10.1002/cam4.2902. Epub 2020 Feb 29.
The value of adjuvant therapy in resected laryngeal cancer remains controversial. This large SEER-based cohort study aimed to investigate the existing parameters of lymph node status that could predict survival outcomes and the prognostic value of adjuvant treatment in resected laryngeal carcinoma.
Population-based data from the US Surveillance, Epidemiology, and End Results (SEER-18) Program on patients after laryngectomy and lymphadenectomy (2004-2015) were analyzed. The optimal cut-off values for examined lymph nodes number (ELNs) and metastatic lymph nodes ratio (MLNR) were determined using the X-tile program. Associations of ELNs and MLNR with overall survival were investigated through Cox regression analysis. A survival-predicting model was then constructed to stratified patients. The prognostic value of adjuvant therapy was evaluated in different subgroups.
A total of 2122 patients with resected laryngeal cancer were analyzed. A novel survival-predicting model was proposed based on ELNs, MLNR, and other clinicopathological characteristics. Patients were stratified into three subgroups with the increasing risk of death. Only patients in the high-risk group who receiving adjuvant treatment had a significantly better survival outcome than those receiving surgery alone.
A new survival-predicting model was established in this study, which was superior in assessing the survival outcomes of patients with resected laryngeal cancer. Notably, this model was also able to assist in the decision making of adjuvant therapy for patients and physicians.
喉癌术后辅助治疗的价值仍存在争议。本大规模 SEER 基于队列研究旨在探讨现有的淋巴结状态参数，这些参数可以预测生存结局，并预测喉癌切除术后辅助治疗的预后价值。
对美国监测、流行病学和最终结果（SEER-18）计划中接受喉切除术和淋巴结切除术（2004-2015 年）的患者进行基于人群的数据进行分析。使用 X-tile 程序确定检查淋巴结数（ELNs）和转移淋巴结比（MLNR）的最佳截断值。通过 Cox 回归分析研究 ELNs 和 MLNR 与总生存的相关性。然后构建一个生存预测模型来分层患者。评估不同亚组中辅助治疗的预后价值。
共分析了 2122 例接受手术治疗的喉癌患者。提出了一种基于 ELNs、MLNR 及其他临床病理特征的新的生存预测模型。根据死亡风险的增加，患者被分为三个亚组。只有高危组中接受辅助治疗的患者，其生存结局明显优于单独接受手术的患者。
本研究建立了一种新的生存预测模型，在评估喉癌患者的生存结局方面具有优势。值得注意的是，该模型还可以帮助患者和医生做出辅助治疗的决策。
