Wang Zekun, Zhang Ye, Zhang Jianghu, Chen Xuesong, Wang Jingbo, Wu Runye, Wang Kai, Qu Yuan, Huang Xiaodong, Luo Jingwei, Gao Li, Xu Guozhen, Liu Shaoyan, Li Ye-Xiong, Yi Junlin
Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Head and Neck Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Cancers (Basel). 2022 Oct 24;14(21):5211. doi: 10.3390/cancers14215211.
Sinonasal squamous cell carcinoma (SNSCC) can arise as either inverted papilloma-associated SCC (IP-SCC) or as de novo SCC (DN-SCC). It is controversial as to whether survival differences between IP-SCC and DN-SCC exist.
Between January 2000 and December 2016, 234 patients with SNSCC were analyzed retrospectively, including 68 with IP-SCC and 166 with DN-SCC. Propensity score matching (PSM) was performed to balance baseline characteristics. The Kaplan-Meier method and Cox proportional hazard model were used to determine risk factors on survival outcomes.
The median follow-up time was 98.4 months. Before PSM, lymph node metastasis was noted to be lower in patients with IP-SCC. After PSM, the 5-year DFS, DSS and OS between IP-SCC and DN-SCC were 43.0% vs. 44.5% ( = 0.701), 49.2% vs. 56.2% ( = 0.753), and 48.2% vs. 52.9% ( = 0.978). The annual hazards of local failure, respectively, peaked at 28.4% and 27.8% for IP-SCC and DN-SCC within 12 months after treatment. Afterward, the hazards gradually decreased and the hazard for IP-SCC was always higher before approaching null.
This study provides novel evidence to support the clinical utility of improved distinction between IP-SCC and DN-SCC. Further studies are necessary to validate these findings before considering escalation of IP-SCC.
鼻窦鳞状细胞癌（SNSCC）可表现为倒置乳头状瘤相关鳞状细胞癌（IP-SCC）或原发性鳞状细胞癌（DN-SCC）。IP-SCC和DN-SCC之间是否存在生存差异存在争议。
回顾性分析2000年1月至2016年12月期间的234例SNSCC患者，其中68例为IP-SCC，166例为DN-SCC。采用倾向评分匹配（PSM）来平衡基线特征。使用Kaplan-Meier法和Cox比例风险模型来确定影响生存结局的危险因素。
中位随访时间为98.4个月。在PSM之前，发现IP-SCC患者的淋巴结转移率较低。PSM后，IP-SCC和DN-SCC之间的5年无病生存率（DFS）、疾病特异性生存率（DSS）和总生存率（OS）分别为43.0%对44.5%（P = 0.701）、49.2%对56.2%（P = 0.753）和48.2%对52.9%（P = 0.978）。IP-SCC和DN-SCC的局部复发年风险分别在治疗后12个月内达到峰值，分别为28.4%和27.8%。此后，风险逐渐降低，IP-SCC的风险在接近零之前始终较高。
本研究提供了新的证据，支持改善IP-SCC和DN-SCC之间区分的临床实用性。在考虑升级IP-SCC治疗之前，有必要进行进一步研究以验证这些发现。
