多原发癌下咽癌患者的临床特征和预后：倾向评分匹配分析。

Clinical characteristics and prognosis of patients with hypopharyngeal cancers with multiple primary cancers: A propensity score matched analysis.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, People's Republic of China.

出版信息

Am J Otolaryngol. 2022 Mar-Apr;43(2):103297. doi: 10.1016/j.amjoto.2021.103297. Epub 2021 Dec 4.

DOI:10.1016/j.amjoto.2021.103297

PMID:34894448

Abstract

PURPOSE

This study aimed to identify the clinical characteristics of hypopharyngeal squamous cell carcinoma (HPSCC) patients with multiple primary cancers (MPCs) and to compare differences between patients with metachronous and synchronous MPCs.

MATERIAL AND METHODS

This study included 219 patients with HPSCC treated at our center between 2008 and 2020; the clinical characteristics and prognosis of 66 patients with MPCs were analyzed. Propensity score matching (PSM) was used to balance the factors between patients with synchronous and metachronous MPCs.

RESULTS

Sixty-six patients with HPSCC (66/219, 30.1%) experienced MPCs, of which 29 were synchronous and 37 were metachronous. The esophagus (n = 39, 59.1%), lung (n = 10, 15.2%), and oropharynx (n = 4, 6.1%) were the three most common sites of MPCs in both the synchronous and metachronous groups. More patients with synchronous MPCs were stage T1-2 (82.8% vs. 59.5%, P = 0.041) compared to those with metachronous MPCs. Among the 24 pairs of patients after PSM, patients with metachronous MPCs had higher 3-year progression-free survival (PFS) (52.5% vs. 16.3%, P < 0.001) and overall survival (OS) (58.5% vs. 22.1%, P = 0.001) than those with synchronous cancers. Multivariate Cox analysis showed that patients with synchronous MPCs had shorter PFS (HR 4.45, 95% CI 1.819-10.885, P = 0.001) and OS (HR 3.918, 95% CI 1.591-9.645, P = 0.003).

CONCLUSION

MPCs are common among patients with HPSCC, and patients with metachronous MPCs had better survival than those with synchronous MPCs. Clinicians should be aware of the possibility of MPCs in patients with HPSCC and optimize treatment to improve outcomes.

摘要

目的

本研究旨在确定患有多原发癌（MPC）的下咽鳞状细胞癌（HPSCC）患者的临床特征，并比较同时性和异时性 MPC 患者之间的差异。

材料与方法

本研究纳入了 2008 年至 2020 年间在我中心治疗的 219 例 HPSCC 患者，分析了 66 例 MPC 患者的临床特征和预后。采用倾向评分匹配（PSM）平衡同时性和异时性 MPC 患者之间的因素。

结果

219 例 HPSCC 患者中有 66 例（66/219，30.1%）发生了 MPC，其中 29 例为同时性 MPC，37 例为异时性 MPC。食管（n=39，59.1%）、肺（n=10，15.2%）和口咽（n=4，6.1%）是同时性和异时性 MPC 中最常见的三个部位。与异时性 MPC 患者相比，更多的同时性 MPC 患者为 T1-2 期（82.8% vs. 59.5%，P=0.041）。在 24 对经过 PSM 后的患者中，异时性 MPC 患者的 3 年无进展生存率（PFS）（52.5% vs. 16.3%，P<0.001）和总生存率（OS）（58.5% vs. 22.1%，P=0.001）均高于同时性癌症患者。多变量 Cox 分析显示，同时性 MPC 患者的 PFS（HR 4.45，95%CI 1.819-10.885，P=0.001）和 OS（HR 3.918，95%CI 1.591-9.645，P=0.003）更短。