阳性淋巴结数量及结外侵犯对涎腺癌患者复发和生存的预测作用
Positive lymph node number and extranodal extension for predicting recurrence and survival in patients with salivary gland cancer.
作者信息
Lee Hojun, Roh Jong-Lyel, Cho Kyung-Ja, Choi Seung-Ho, Nam Soon Yuhl, Kim Sang Yoon
机构信息
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
出版信息
Head Neck. 2020 Aug;42(8):1994-2001. doi: 10.1002/hed.26135. Epub 2020 Mar 1.
BACKGROUND
This study compared our proposed N classification including the addition of the number of positive lymph node (LN+) and extranodal extension (ENE) with the current and previous American Joint Committee on Cancer (AJCC) N classifications in salivary gland cancer (SGC).
METHODS
This study involved 172 SGC patients who underwent surgery. Cox proportional hazard regression analyses were used to identify factors associated with overall survival (OS) and disease-free survival (DFS).
RESULTS
In multivariate analyses, LN+ number, LN ratio, and ENE were associated with OS and DFS outcomes (all P < .05). Our new N classification proposed three categories: N0 (0 LN+), N1 (1 LN+), and N2 (≥2 LN+ or ENE). The C-index of our N classification showed improvement in OS prediction (0.768) compared with the AJCC seventh (0.743) and eighth (0.756) edition N classifications.
CONCLUSIONS
Our proposed N classification incorporating LN+ number and ENE may improve prediction of post-treatment survival and recurrence in patients with SGC.
背景
本研究将我们提出的N分类（包括阳性淋巴结数量（LN+）和结外侵犯（ENE））与美国癌症联合委员会（AJCC）目前和以往的唾液腺癌（SGC）N分类进行了比较。
方法
本研究纳入了172例行手术的SGC患者。采用Cox比例风险回归分析确定与总生存（OS）和无病生存（DFS）相关的因素。
结果
在多变量分析中，LN+数量、LN比例和ENE与OS和DFS结局相关（均P < 0.05）。我们新提出的N分类分为三类：N0（0个LN+）、N1（1个LN+）和N2（≥2个LN+或ENE）。与AJCC第七版（0.743）和第八版（0.756）N分类相比，我们的N分类的C指数在OS预测方面有所改善（0.768）。
结论
我们提出的纳入LN+数量和ENE的N分类可能会改善SGC患者治疗后生存和复发的预测。
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