巴西圣保罗口咽鳞状细胞癌的预后因素：10 年随访。
Prognostic factors in oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil: 10-year follow-up.
机构信息
Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
Universidade Estadual de Campinas (Unicamp), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
出版信息
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 4(Suppl 4):S124-S132. doi: 10.1016/j.bjorl.2022.07.003. Epub 2022 Aug 5.
OBJECTIVE
To descriptively analyze the epidemiological data, clinical stage, and outcomes of oropharyngeal squamous cell carcinoma in the state of São Paulo, Brazil, and to estimate the influence of clinical stage and treatment type on overall and disease-free survival.
METHODS
We retrospectively analyzed epidemiological data from the São Paulo Cancer Center Foundation database relative to patients with oropharyngeal squamous cell carcinoma diagnosed between 2004 and 2014 in the state of São Paulo. Univariate and multivariate Cox regression analyses were performed to assess factors associated with the outcomes. A forward stepwise selection procedure was used. Survival curves were estimated by the Kaplan-Meier method and compared by the Gehan-Breslow-Wilcoxon test.
RESULTS
A total of 8075 individuals with oropharyngeal squamous cell carcinoma were identified. Of these, 86.3% were diagnosed at an advanced stage and 13.7% at an early stage. Only 27.2% of patients were treated surgically, whereas 57.5% were treated medically. Patients undergoing surgery had longer overall survival than those receiving medical treatment in both early- and advanced-stage oropharyngeal squamous cell carcinoma. However, there was no significant difference in disease-free survival between surgical and medical treatment.
CONCLUSION
No significant difference in disease-free survival between medical and surgical treatment suggests similar complete remission rates with both approaches. Patients receiving medical treatment had shorter overall survival, which may be due to complications from chemotherapy and radiotherapy. However, we cannot confirm this relationship based on the data provided by the São Paulo Cancer Center Foundation. Prospective studies are warranted to assess whether the lower overall survival rate in patients receiving medical treatment is secondary to complications from chemotherapy and radiotherapy.
LEVEL OF EVIDENCE
2C.
目的
描述性分析巴西圣保罗州口咽鳞状细胞癌的流行病学数据、临床分期和结局，并评估临床分期和治疗类型对总生存和无病生存的影响。
方法
我们回顾性分析了巴西圣保罗癌症中心基金会数据库中 2004 年至 2014 年期间诊断为口咽鳞状细胞癌的患者的流行病学数据。采用单因素和多因素 Cox 回归分析评估与结局相关的因素。采用向前逐步选择程序。采用 Kaplan-Meier 法估计生存曲线，并采用 Gehan-Breslow-Wilcoxon 检验进行比较。
结果
共纳入 8075 例口咽鳞状细胞癌患者，其中 86.3%诊断为晚期，13.7%诊断为早期。仅有 27.2%的患者接受手术治疗，而 57.5%接受药物治疗。在早期和晚期口咽鳞状细胞癌中，接受手术治疗的患者总生存时间长于接受药物治疗的患者。然而，手术和药物治疗在无病生存方面无显著差异。
结论
手术和药物治疗在无病生存方面无显著差异，提示两种方法的完全缓解率相似。接受药物治疗的患者总生存时间较短，这可能是由于化疗和放疗的并发症所致。然而，我们不能仅根据圣保罗癌症中心基金会提供的数据来证实这种关系。需要前瞻性研究来评估接受药物治疗的患者总生存率较低是否继发于化疗和放疗的并发症。
证据水平
2C。
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