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鼻窦鳞状细胞癌:单中心经验

Squamous Cell Carcinoma of the Paranasal Sinuses: A Single Center Experience.

作者信息

König Marton, Osnes Terje, Bratland Åse, Meling Torstein R

机构信息

Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

出版信息

J Neurol Surg B Skull Base. 2020 Dec;81(6):664-672. doi: 10.1055/s-0039-1694967. Epub 2019 Aug 5.

Abstract

Squamous cell carcinoma (SCC) of the paranasal sinuses is usually diagnosed at an advanced stage, making curative therapy difficult. The goal of this study was to evaluate the management and outcomes of patients with SCC treated at our institution.  In a population-based consecutive prospective cohort, we conducted an analysis of all patients treated for SCC between 1988 and 2017.  A total of 72 patients were included, follow-up was 100%. Mean follow-up was 57 months for the entire cohort, and 108 months for patients with no evidence of disease. Eighty-two percent of all patients had high-stage (T4) disease. Fifty-seven patients underwent treatment with curative intent; consisting of surgery with or without oncologic treatment in 34, and of oncologic treatment only in 23 cases. Fifteen patients received palliative treatment. The rates of overall survival for the entire cohort were 55% at 2, 41% at 5, and 32% at 10 years, and corresponding disease-specific survival (DSS) rates were 55, 45, and 34%, respectively. DSS rates after surgical treatment with curative intent were 81% at 2, 65% at 5, and 54% at 10 years. Retromaxillary involvement and nonradical surgery were negative prognostic factors. Best survival was achieved with the combination of radical surgery and adjuvant oncologic treatment.  Surgical resection with a curative intent yielded 65% at 5-year DSS even in this cohort of patients with high-stage SCC and is still considered as the treatment of choice, preferably in combination with adjuvant radiation therapy and chemotherapy.

摘要

鼻窦鳞状细胞癌(SCC)通常在晚期才被诊断出来,这使得根治性治疗变得困难。本研究的目的是评估在我们机构接受治疗的鼻窦鳞状细胞癌患者的治疗情况和预后。

在一项基于人群的连续前瞻性队列研究中,我们对1988年至2017年间所有接受鼻窦鳞状细胞癌治疗的患者进行了分析。

总共纳入了72例患者,随访率为100%。整个队列的平均随访时间为57个月,无疾病证据的患者平均随访时间为108个月。所有患者中有82%患有高分期(T4)疾病。57例患者接受了根治性治疗;其中34例接受了手术治疗,可选择是否进行肿瘤治疗,23例仅接受了肿瘤治疗。15例患者接受了姑息治疗。整个队列的总生存率在2年时为55%,5年时为41%,10年时为32%,相应的疾病特异性生存率(DSS)分别为55%、45%和34%。根治性手术治疗后的DSS率在2年时为81%,5年时为65%,10年时为54%。上颌后份受累和非根治性手术是不良预后因素。根治性手术与辅助肿瘤治疗相结合可获得最佳生存率。

即使在这个高分期鼻窦鳞状细胞癌患者队列中,根治性手术切除后的5年DSS率仍为65%,手术切除仍然被认为是首选治疗方法,最好与辅助放疗和化疗相结合。

相似文献

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Squamous Cell Carcinoma of the Paranasal Sinuses: A Single Center Experience.鼻窦鳞状细胞癌:单中心经验
J Neurol Surg B Skull Base. 2020 Dec;81(6):664-672. doi: 10.1055/s-0039-1694967. Epub 2019 Aug 5.
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