复发性鼻窦鼻腔癌症的挽救性手术：基于临床病理和治疗相关参数的预后模型的建议。
Salvage surgery in recurrent sinonasal cancers: Proposal for a prognostic model based on clinicopathologic and treatment-related parameters.
机构信息
Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
出版信息
Head Neck. 2022 Aug;44(8):1857-1870. doi: 10.1002/hed.27102. Epub 2022 Jun 2.
BACKGROUND
Evidence on survival and major prognosticators after salvage surgery in recurrent sinonasal cancers (SNC) is limited.
METHODS
A retrospective, single-center study of recurrent SNC treated with salvage surgery between 1997 and 2019 was conducted. Univariate and multivariable analyses were performed to define a prognostic score for overall survival (OS).
RESULTS
One hundred and eighteen patients were included. Recurrent SNC originated mostly in the naso-ethmoidal box (67.8%) and were mainly epithelial (76.2%), high-grade (49.2%), and locally advanced (rpT4, 60.1%) malignancies. Negative margins were achieved in 56.6% of cases. Two- and 5-year OS were 71.7% and 56%, respectively. The prognostic model included treatment modality for primary tumor, histology, rpT class, margin status, perineural invasion, and adjuvant radiotherapy and stratified patients into three prognostic groups (5-year OS: 84.4%, 44.9%, and 0%, respectively).
CONCLUSIONS
Treatment of recurrent SNC can result in good long-term survival estimates with limited morbidity. Our score can provide excellent prognostic stratification.
背景
关于复发性鼻腔鼻窦癌（SNC）经挽救性手术后的生存和主要预后因素的证据有限。
方法
对 1997 年至 2019 年间接受挽救性手术治疗的复发性 SNC 患者进行了回顾性、单中心研究。采用单因素和多因素分析方法，确定总生存（OS）的预后评分。
结果
共纳入 118 例患者。复发性 SNC 主要起源于鼻-筛窦（67.8%），主要为上皮性（76.2%）、高级别（49.2%）和局部晚期（rpT4，60.1%）恶性肿瘤。56.6%的病例达到了阴性切缘。2 年和 5 年 OS 分别为 71.7%和 56%。该预后模型包括原发肿瘤的治疗方式、组织学、rpT 分级、切缘状态、神经周围侵犯以及辅助放疗，并将患者分为三个预后组（5 年 OS：分别为 84.4%、44.9%和 0%）。
结论
复发性 SNC 的治疗可以获得良好的长期生存估计，同时发病率有限。我们的评分可以提供出色的预后分层。
Zotero 插件