口咽鳞状细胞癌远处转移及生存情况的特征分析
Characterizing distant metastases and survival in oropharyngeal squamous cell carcinoma.
作者信息
Saiyed Faiez K, Guo Theresa, Johnson Faye, Myers Jeffrey N
机构信息
Department of Otolaryngology - Head and Neck Surgery, University of Maryland, Baltimore, Maryland, USA.
Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
出版信息
Head Neck. 2021 Jul;43(7):2101-2109. doi: 10.1002/hed.26678. Epub 2021 Mar 19.
BACKGROUND
Outcomes of oropharyngeal squamous cell carcinoma (OPSCC) after development of distant metastases (DM) in the context of human papillomavirus (HPV) tumor status remain controversial in the literature.
METHODS
OPSCC patients with DM treated between June 2015 and March 2019 were included from a prospectively enrolled database. Characteristics of DM including sites, episodes, and timing of disease were analyzed in addition to survival after DM.
RESULTS
Sixty-nine HPV-positive and 18 HPV-negative OPSCC patients with DM were included. The 2-year survival after DM was higher for HPV-positive patients (54.0% vs. 11.3%, p < 0.001). HPV-positive patients did not demonstrate greater episodes or sites of DM. Multiple sites of DM, early development of DM, and Charlson comorbidity Index were independently associated with worse survival after DM.
CONCLUSIONS
While multiple sites, early DM, and comorbidities were poor prognostic factors, OPSCC patients with distant progression can have substantial survival after DM, including M1 patients.
背景
在人乳头瘤病毒（HPV）肿瘤状态背景下，口咽鳞状细胞癌（OPSCC）发生远处转移（DM）后的预后在文献中仍存在争议。
方法
从一个前瞻性登记数据库中纳入2015年6月至2019年3月期间接受治疗的发生DM的OPSCC患者。除了DM后的生存情况外，还分析了DM的特征，包括部位、发作次数和疾病发生时间。
结果
纳入了69例HPV阳性和18例HPV阴性的发生DM的OPSCC患者。HPV阳性患者DM后的2年生存率更高（54.0%对11.3%，p<0.001）。HPV阳性患者的DM发作次数或部位并未更多。DM的多个部位、DM的早期发生以及查尔森合并症指数与DM后的较差生存独立相关。
结论
虽然多个部位、早期DM和合并症是不良预后因素，但发生远处进展的OPSCC患者在DM后仍可获得可观的生存期，包括M1期患者。
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