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[年龄校正的Charlson合并症指数在60岁以上喉鳞状细胞癌患者中的预后价值]

[Prognostic value of the age-adjusted Charlson comorbidity index in patients over 60 years old with laryngeal squamous cell carcinoma].

作者信息

Li Z L, An C M, Gao Z H, Cao J Z, Huangfu H, Nan J, Zhu B Y, Zhang Y

机构信息

Department of Head and Neck Surgery, Shanxi Provincial Cancer Hospital, Taiyuan 030013, China.

Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Caner/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug 7;56(8):837-843. doi: 10.3760/cma.j.cn115330-20201124-00890.

Abstract

To evaluate the value of the age-adjusted Charlson comorbidity Index (ACCI) in predicting the prognosis and guiding the clinical treatment of laryngeal squamous cell carcinoma (LSCC) in patients over 60 years old. Retrospective analysis of 249 cases of LSCC in Shanxi Provincial Cancer Hospital and First Hospital of Shanxi Medical University from 2008 to 2015 was performed. There were 234 males and 15 females, aged from 60 to 88 years. The clinical characteristics, treatment information and follow-up data were collected. ACCI was used to score the comorbidities of the patients. Receiver operating characteristic (ROC) curve was drawn and the patients were divided into high ACCI group and low ACCI group according to the cut-off value of ACCI. Prognostic factors were analyzed. Kaplan-Meier method was used for survival analysis, rank sum test was used for comparison between groups, χ test was used for enumeration data. Overall survival (OS) was 54.6%, progression-free survival (PFS) was 59.4%, and cancer-specific survival (CSS) was 58.6%. Both the median survival time and PFS time were 60 months. The best cutoff point of the ACCI group was 5. Cox multivariate analysis showed that ACCI was an independent risk factor for OS, PFS and CSS (=1.553, 1.499 and 1.534,respectively, all <0.05). In the high ACCI group, OS (χ=4.120 and 4.115,<0.05) and CSS (χ=4.510 and 5.009,<0.05) of patients treated with surgery plus radiotherapy and patients with radiotherapy alone were better than those of patients with surgery alone (<0.05). But in the low ACCI group, there was no significant difference in prognosis among the three treatment regimens (>0.05). High ACCI offors important prognostic information for LSCC in patients over 60 years old, and can guide clinical treatment options.

摘要

评估年龄校正的Charlson合并症指数(ACCI)在预测60岁以上喉鳞状细胞癌(LSCC)患者预后及指导临床治疗中的价值。对山西省肿瘤医院和山西医科大学第一医院2008年至2015年收治的249例LSCC患者进行回顾性分析。其中男性234例,女性15例,年龄60至88岁。收集患者的临床特征、治疗信息及随访数据。采用ACCI对患者的合并症进行评分。绘制受试者工作特征(ROC)曲线,并根据ACCI的截断值将患者分为高ACCI组和低ACCI组。分析预后因素。采用Kaplan-Meier法进行生存分析,组间比较采用秩和检验,计数资料采用χ检验。总生存(OS)率为54.6%,无进展生存(PFS)率为59.4%,癌症特异性生存(CSS)率为58.6%。中位生存时间和PFS时间均为60个月。ACCI组的最佳截断点为5。Cox多因素分析显示,ACCI是OS、PFS和CSS的独立危险因素(分别为=1.553、1.499和1.534,均<0.05)。在高ACCI组中,接受手术加放疗的患者和单纯放疗患者的OS(χ=4.120和4.115,<0.05)及CSS(χ=4.510和5.009,<0.05)均优于单纯手术患者(<0.05)。但在低ACCI组中,三种治疗方案的预后差异无统计学意义(>0.05)。高ACCI为60岁以上LSCC患者提供了重要的预后信息,并可指导临床治疗方案的选择。

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