Allegra Eugenia, Bianco Maria Rita, Ralli Massimo, Greco Antonio, Angeletti Diletta, de Vincentiis Marco
Department of Health Science, University of Catanzaro, 88100 Catanzaro, Italy.
Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy.
Medicina (Kaunas). 2021 Mar 15;57(3):267. doi: 10.3390/medicina57030267.
: Laryngeal cancer is one of the most common cancers in the upper aerodigestive tract, and tobacco and alcohol habits are the most relevant risk factors. The role of these risk factors in the incidence of laryngeal carcinomas is well known, yet only a few studies have been conducted on their role as risk factors of prognosis. The aim of the study was to assess the impact of clinical-demographic data on overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) in patients with advanced-stage laryngeal cancer (Stage III-IV) who underwent total laryngectomy. : This retrospective study was carried out on patients with Stage III-IV laryngeal squamous cell carcinoma treated with total laryngectomy between 2004 and 2014. For each patient, clinical and anamnestic data were collected and collated in a database, including alcohol and smoking habits. : Considering the variable age, family history, alcohol, grading, subsite, stage, pT stage, pN stage, and adjuvant therapy, no statistical significance was found for five-year OS. Smoking was the only variable that was statistically significant ( = 0.0043). A relevant difference was noted in the five-year DFS between pN-negative and pN-positive tumors (74.3% vs. 55.26%, respectively; = 0.056), and a statistically significant difference was found between non- and ≤20 cigarettes/day smokers and heavy smokers (77.78% vs. 53.66%, respectively; = 0.021). The five-year disease-specific survival rate was 68.83%, and a significant difference was detected for the smoking and pN stage variables. Heavy smokers (43.90% died vs. 16.67% of the non- and ≤20 cigarettes/day smokers; = 0.0057) and pN-positive (42.1% died vs. 20.51% of the pN-negative patients; = 0.042) patients had a worse prognosis. : Smoking in our study was found to be an important independent risk factor for worse OS and DSS in patients with advanced laryngeal cancer.
喉癌是上呼吸道消化道最常见的癌症之一，吸烟和饮酒习惯是最相关的风险因素。这些风险因素在喉癌发病率中的作用是众所周知的，但关于它们作为预后风险因素的作用，仅有少数研究。本研究的目的是评估临床人口统计学数据对接受全喉切除术的晚期喉癌（III-IV期）患者总生存期（OS）、无病生存期（DFS）和疾病特异性生存期（DSS）的影响。
这项回顾性研究针对2004年至2014年间接受全喉切除术治疗的III-IV期喉鳞状细胞癌患者开展。为每位患者收集临床和既往史数据，并整理到一个数据库中，包括饮酒和吸烟习惯。
考虑到年龄、家族史、饮酒、分级、亚部位、分期、pT分期、pN分期和辅助治疗等变量，五年总生存期未发现统计学意义。吸烟是唯一具有统计学意义的变量（P = 0.0043）。pN阴性和pN阳性肿瘤的五年无病生存期存在显著差异（分别为74.3%和55.26%；P = 0.056），每天吸烟不超过20支的吸烟者与重度吸烟者之间存在统计学显著差异（分别为77.78%和53.66%；P = 0.021）。五年疾病特异性生存率为68.83%，吸烟和pN分期变量存在显著差异。重度吸烟者（43.90%死亡，而每天吸烟不超过20支的吸烟者为16.67%；P = 0.0057）和pN阳性患者（42.1%死亡，而pN阴性患者为20.51%；P = 0.042）的预后较差。
在我们的研究中，吸烟被发现是晚期喉癌患者总生存期和无病生存期较差的重要独立风险因素。
