Dittberner Andreas, Friedl Benedikt, Wittig Andrea, Buentzel Jens, Kaftan Holger, Boeger Daniel, Mueller Andreas H, Schultze-Mosgau Stefan, Schlattmann Peter, Ernst Thomas, Guntinas-Lichius Orlando
Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany.
Department of Radiotherapy and Radiation Oncology, Jena University Hospital, 07747 Jena, Germany.
Cancers (Basel). 2020 Nov 18;12(11):3418. doi: 10.3390/cancers12113418.
This study determined with focus on gender disparity whether incidence based on age, tumor characteristics, patterns of care, and survival have changed in a population-based sample of 8288 German patients with head neck cancer (HNC) registered between 1996 and 2016 in Thuringia, a federal state in Germany. The average incidence was 26.13 ± 2.89 for men and 6.23 ± 1.11 per 100,000 population per year for women. The incidence peak for men was reached with 60-64 years (63.61 ± 9.37). Highest incidence in females was reached at ≥85 years (13.93 ± 5.87). Multimodal concepts increased over time (RR = 1.33, CI = 1.26 to 1.40). Median follow-up time was 29.10 months. Overall survival (OS) rate at 5 years was 48.5%. The multivariable analysis showed that male gender (Hazard ratio [HR] = 1.44; CI = 1.32 to 1.58), tumor subsite (worst hypopharyngeal cancer: HR = 1.32; CI = 1.19 to 1.47), and tumor stage (stage IV: HR = 3.40; CI = 3.01 to 3.85) but not the year of diagnosis (HR = 1.00; CI = 0.99 to 1.01) were independent risk factors for worse OS. Gender has an influence on incidence per age group and tumor subsite, and on treatment decision, especially in advanced stage and elderly HNC patients.
本研究聚焦性别差异，探讨了在德国图林根州1996年至2016年间登记的8288例头颈部癌（HNC）患者的基于人群的样本中，年龄、肿瘤特征、治疗模式和生存率的发病率是否发生了变化。男性的平均发病率为每年每10万人口26.13±2.89例，女性为6.23±1.11例。男性发病率高峰出现在60 - 64岁（63.61±9.37）。女性最高发病率出现在85岁及以上（13.93±5.87）。多模式治疗理念随时间增加（相对风险[RR]=1.33，可信区间[CI]=1.26至1.40）。中位随访时间为29.10个月。5年总生存率（OS）为48.5%。多变量分析显示，男性性别（风险比[HR]=1.44；CI=1.32至1.58）、肿瘤亚部位（最差的下咽癌：HR=1.32；CI=1.19至1.47）和肿瘤分期（IV期：HR=3.40；CI=3.01至3.85）而非诊断年份（HR=1.00；CI=0.99至1.01）是OS较差的独立危险因素。性别对各年龄组和肿瘤亚部位的发病率以及治疗决策有影响，尤其是在晚期和老年HNC患者中。
