声门下型鳞状细胞癌患者的生存结局：国家癌症数据库研究。
Survival outcomes of patients with subglottic squamous cell carcinoma : a study of the National Cancer Database.
机构信息
Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, OH, USA.
Department of Head and Neck-Endocrine Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
出版信息
Eur Arch Otorhinolaryngol. 2021 Dec;278(12):4923-4932. doi: 10.1007/s00405-021-06712-w. Epub 2021 Mar 1.
BACKGROUND
Subglottic squamous cell carcinoma (SCC) represents less than 5% of all laryngeal cancers. Our objective was to better characterize survival using the National Cancer Database (NCDB) registry from 2004 to 2015.
RESULTS
403 patients met inclusion criteria. 63.8% presented with advanced-stage disease. Treatment regimens were as follows: 15.9% underwent surgery alone, 16.9% underwent surgery followed by adjuvant therapy, and 67.2% underwent primary chemo/radiation (C/RT). Five-year overall survival (OS) was 58.6% for Stage I and II patients, 49.1% for Stage III, and 36.3% for stage IV. Adjusted OS for all-stage patients was worse with C/RT compared to upfront surgery (40.6% vs. 58.4%; HR 1.83 [95%CI 1.29-2.61] p < 0.001) and adjusted OS for stage 4 disease was significantly worse with C/RT compared to surgery (26.0% vs. 45.2%, HR 1.79 [95%CI 1.17-2.73] p = 0.007).
CONCLUSION
Majority of patients were treated with primary C/RT. Adjusted survival favors upfront surgery versus C/RT, especially in patients with Stage IV disease.
背景
声门下鳞状细胞癌（SCC）占所有喉癌的比例不足 5%。我们的目的是利用 2004 年至 2015 年国家癌症数据库（NCDB）登记数据更好地描述生存率。
结果
403 例患者符合纳入标准。63.8%的患者为晚期疾病。治疗方案如下：15.9%的患者单纯接受手术，16.9%的患者接受手术联合辅助治疗，67.2%的患者接受初始放化疗（C/RT）。Ⅰ期和Ⅱ期患者的 5 年总生存率（OS）为 58.6%，Ⅲ期为 49.1%，Ⅳ期为 36.3%。与初始手术相比，所有分期患者接受 C/RT 的调整后 OS 更差（40.6%比 58.4%；HR 1.83[95%CI 1.29-2.61]，p<0.001），与手术相比，Ⅳ期疾病接受 C/RT 的调整后 OS 明显更差（26.0%比 45.2%，HR 1.79[95%CI 1.17-2.73]，p=0.007）。
结论
大多数患者接受初始 C/RT 治疗。与 C/RT 相比，初始手术的调整后生存率更优，尤其是在Ⅳ期疾病患者中。
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