临床T1-2、N0口咽鳞状细胞癌患者的临床表现及预后：主要治疗方式与人乳头瘤病毒状态的相互作用
Presentation and outcomes of patients with clinically T1-2, N0 oropharynx squamous cell carcinoma: The interplay of primary treatment modality and human papillomavirus status.
作者信息
Al-Qurayshi Zaid, Zhu Vivian L, Bayon Rodrigo, Buchakjian Marisa R
机构信息
Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
出版信息
Head Neck. 2023 Jan;45(1):64-74. doi: 10.1002/hed.27211. Epub 2022 Oct 7.
BACKGROUND
To examine the pattern of utilization and outcomes of definitive radiotherapy (RT) versus primary robotic-assisted surgery in patients with early-stage oropharyngeal squamous cell carcinoma (OPSCC).
METHODS
A retrospective cohort analysis of patients with clinically T1-2, N0 OPSCC was performed using the National Cancer Database, 2010-2016.
RESULTS
A total of 1451 patients were included. Prevalence of human papillomavirus (HPV)-positive tumors was 58.30%. Primary surgery was performed in 30.25% of the sample. Tongue base and clinically T1 tumors were each associated with a higher likelihood of undergoing surgery (p < 0.05). Histopathology of patients who underwent surgery demonstrated a prevalence of 15.95% with lymphovascular invasion, 16.67% with extranodal extension, 19.36% were T updated, and 30.00% were N upstaged. Improved survival was observed in the surgery + adjuvant RT group compared to RT alone for HPV-positive tumors (HR: 0.27; 95%CI: 0.12, 0.62; p = 0.002).
CONCLUSION
This study provides epidemiological perspective regarding management pattern and outcomes of patients with early-stage OPSCC.
背景
研究早期口咽鳞状细胞癌（OPSCC）患者中确定性放疗（RT）与原发性机器人辅助手术的使用模式及结果。
方法
利用国家癌症数据库对2010 - 2016年临床T1 - 2、N0期OPSCC患者进行回顾性队列分析。
结果
共纳入1451例患者。人乳头瘤病毒（HPV）阳性肿瘤的患病率为58.30%。30.25%的样本接受了原发性手术。舌根癌和临床T1期肿瘤患者接受手术的可能性更高（p < 0.05）。接受手术患者的组织病理学显示，15.95%有淋巴管侵犯，16.67%有结外扩展，19.36%的T分期上调，30.00%的N分期上调。对于HPV阳性肿瘤，手术联合辅助放疗组与单纯放疗组相比，生存率有所提高（HR：0.27；95%CI：0.12，0.62；p = 0.002）。
结论
本研究提供了关于早期OPSCC患者管理模式和结果的流行病学观点。
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