组织学分型中种族对鼻咽癌预后的意义。
The prognostic significance of race in nasopharyngeal carcinoma by histological subtype.
机构信息
Department of Otolaryngology, Washington University School of Medicine, St Louis, Missouri, USA.
Division of Public Health Sciences, Department of Surgery, Washington University, St Louis, Missouri, USA.
出版信息
Head Neck. 2021 Jun;43(6):1797-1811. doi: 10.1002/hed.26639. Epub 2021 Feb 23.
BACKGROUND
Race has been shown to have variable prognostic importance in nasopharyngeal carcinoma (NPC). However, previous studies are limited by a lack of comprehensive treatment, epidemiologic, and comorbidity data.
METHODS
This was a retrospective cohort study utilizing the National Cancer Database from 2004 to 2016. Multivariable Cox proportional hazards regressions were used to calculate adjusted hazard ratios (aHR) for overall survival.
RESULTS
A cohort of 9995 patients met inclusion and exclusion criteria. Race, insurance, comorbidity, treatment, stage, age, and histology were independent prognosticators. Among patients with keratinizing NPC, Asians and Hispanics had superior survival (aHR 0.58 [95% confidence interval (CI) 0.48-0.69], aHR 0.76 [95% CI 0.61-0.96]) compared to white patients. Among patients with non-keratinizing differentiated NPC, Asians and black patients had improved survival (aHR 0.71 [95% CI 0.56-0.91], aHR 0.72 [95% CI 0.54-0.95]) compared to white patients. Race was not prognostic in non-keratinizing undifferentiated NPC.
CONCLUSION
The prognostic significance of race varies across histological subtypes of NPC.
背景
种族在鼻咽癌（NPC）中具有不同的预后重要性。然而，以前的研究受到缺乏综合治疗、流行病学和合并症数据的限制。
方法
这是一项利用 2004 年至 2016 年国家癌症数据库进行的回顾性队列研究。多变量 Cox 比例风险回归用于计算总体生存的调整后危险比（aHR）。
结果
一个符合纳入和排除标准的队列纳入了 9995 名患者。种族、保险、合并症、治疗、分期、年龄和组织学是独立的预后因素。在角化 NPC 患者中，亚洲人和西班牙裔患者的生存率优于白人患者（aHR 0.58 [95%CI 0.48-0.69]，aHR 0.76 [95%CI 0.61-0.96]）。在非角化分化型 NPC 患者中，亚洲人和黑人患者的生存率优于白人患者（aHR 0.71 [95%CI 0.56-0.91]，aHR 0.72 [95%CI 0.54-0.95]）。非角化未分化型 NPC 中，种族无预后意义。
结论
种族在 NPC 的组织学亚型之间具有不同的预后意义。
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