Gong Hongli, Zhou Liang, Tao Lei, Zhang Ming, Wu Haitao, Chen Xiaoling, Li Xiaoming, Li Cai, Zhou Jian
Department of Otolaryngology Head and Neck Surgery，Eye & ENT Hospital of Fudan University，Shanghai，200031，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Apr;35(4):316-320. doi: 10.13201/j.issn.2096-7993.2021.04.007.
The aim of this study was to evaluate the predicting role of tumor volume as evaluated by postoperative pathologic examination on overall survival（OS） and disease free survival（DFS） in patients with local advanced glottic carcinoma. In this study, the records of 406 consecutive patients with local advanced glottic carcinoma（T3-T4 stages） who underwent surgery ± chemoradiotherapy from January 2005 to December 2010 were retrospectively reviewed and followed up. The demographic characteristics, disease staging, and pathologic tumor volume were analyzed. The optimal cutoff values of tumor volume for OS and DFS were obtained by using receiver operating characteristic（ROC） curves. The association of tumor volume with T stages were assessed by using Logistic regression model, and the relationship between tumor volume and OS and DFS rates were evaluated by using Cox regression models. The 5-and 10-year OS rates were 62.9% and 55.4%, respectively. The 5-and 10-year DFS rates were 55.5% and 50.8%, respectively. The mean tumor volume was（5.1±6.7） cm³, T4 stage patients had higher tumor volume than those of patients with T3 stage（<0.001）. The factor of tumor volume was correlated with T stages by using Logistic regression analyses（=13.81, 95%: 6.03-31.59, <0.001）. The optimal cutoff values of tumor volume that were both at 3 cm³ for OS and DFS rates were obtained by using ROC curve plots. The OS and DFS rates of glottic carcinoma patients with tumor volume ≤ 3 cm³ were better when compared with those of patients with tumor volume>3 cm³（<0.001）. Upon multivariate analyses, tumor volume was strongly correlated with poorer OS and DFS rates and remained independent prognostic factors for both the OS and DFS of patients with glottic carcinoma（OS: =1.59, 95%: 1.09-2.32, ＝0.017; DFS: =1.54, 95%: 1.08-2.20, =0.016）. This study demonstrates that tumor volume is correlated with T stages, and this factor is an independent predictive factor of survival outcomes in patients with local advanced glottic carcinoma.
本研究旨在评估术后病理检查所评估的肿瘤体积对局部晚期声门癌患者总生存期（OS）和无病生存期（DFS）的预测作用。在本研究中，回顾性分析并随访了2005年1月至2010年12月期间连续406例行手术±放化疗的局部晚期声门癌（T3 - T4期）患者的记录。分析了患者的人口统计学特征、疾病分期和病理肿瘤体积。通过绘制受试者工作特征（ROC）曲线得出OS和DFS的肿瘤体积最佳截断值。采用Logistic回归模型评估肿瘤体积与T分期的相关性，采用Cox回归模型评估肿瘤体积与OS及DFS率之间的关系。5年和10年OS率分别为62.9%和55.4%。5年和10年DFS率分别为55.5%和50.8%。平均肿瘤体积为（5.1±6.7）cm³，T4期患者的肿瘤体积高于T3期患者（<0.001）。通过Logistic回归分析，肿瘤体积因素与T分期相关（=13.81，95%置信区间：6.03 - 31.59，<0.001）。通过ROC曲线绘制得出OS和DFS率的肿瘤体积最佳截断值均为3 cm³。肿瘤体积≤3 cm³的声门癌患者的OS和DFS率优于肿瘤体积>3 cm³的患者（<0.001）。多因素分析显示，肿瘤体积与较差的OS和DFS率密切相关，并且仍然是声门癌患者OS和DFS的独立预后因素（OS：=1.59，95%置信区间：1.09 - 2.32，＝0.017；DFS：=1.54，95%置信区间：1.08 - 2.20，=0.016）。本研究表明，肿瘤体积与T分期相关，并且该因素是局部晚期声门癌患者生存结局的独立预测因素。
