年轻喉癌患者的特征和结局：全国基于医院的回顾性队列分析。

Characteristics and outcomes of young patients with laryngeal cancer: National hospital-based retrospective cohort analysis.

机构信息

Department of Otolaryngology - Head and Neck Surgery, UT Southwestern Medical Center, Dallas, Texas, USA.

Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas, USA.

出版信息

Head Neck. 2022 Oct;44(10):2095-2108. doi: 10.1002/hed.27120. Epub 2022 Jun 16.

DOI:10.1002/hed.27120

PMID:35708157

Abstract

BACKGROUND

The relative incidence of laryngeal cancer is rising in young patients, yet their characteristics, risk factors, and outcomes relative to older patients are poorly understood.

METHODS

Retrospective cohort analysis of the National Cancer Database from 2006 to 2015.

RESULTS

Among 25 029 total patients, 923 (3.7%) were young (<45 years old) and 3266 underwent tumor HPV testing. Compared to older patients, a greater proportion of young patients were female (30.3%, 23.3%; p < 0.001) and seen with high-risk HPV-positive tumors (29.9%, 12.4%; p < 0.001). In subset analyses of young patients, females with higher income (≥$38 000) exhibited a decreased risk of overall mortality compared to all other sex-income subcategories (adjusted hazard ratio [aHR]: 0.43, 95% confidence interval [CI]: 0.25-0.72). In subset analyses of patients of all ages with known tumor HPV status, patients with high-risk HPV-positive tumors exhibited a reduced risk of all-cause mortality (aHR: 0.74, 95%CI: 0.60-0.92, p = 0.007).

CONCLUSION

The interdependent associations between age, sex, tumor HPV status, and income on laryngeal cancer outcomes warrant further investigation.

摘要

背景

喉癌在年轻患者中的相对发病率正在上升，但人们对其特征、危险因素以及与老年患者相比的预后知之甚少。

方法

回顾性队列分析了 2006 年至 2015 年国家癌症数据库中的数据。

结果

在 25029 例患者中，有 923 例（3.7%）为年轻患者（<45 岁），其中 3266 例行肿瘤 HPV 检测。与老年患者相比，年轻患者中女性患者所占比例更高（30.3%，23.3%；p<0.001），且更多见高危型 HPV 阳性肿瘤（29.9%，12.4%；p<0.001）。在年轻患者的亚组分析中，高收入（≥38000 美元）的女性患者与其他所有性别收入亚组相比，总体死亡率风险降低（调整后危险比[aHR]：0.43，95%置信区间[CI]：0.25-0.72）。在所有年龄已知肿瘤 HPV 状态的患者的亚组分析中，高危型 HPV 阳性肿瘤患者的全因死亡率降低（aHR：0.74，95%CI：0.60-0.92，p=0.007）。