Licci Giuseppe, Locatello Luca Giovanni, Maggiore Giandomenico, Cozzolino Flavia, Caini Saverio, Gallo Oreste
Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy.
Department of Otorhinolaryngology, Academic Hospital "Santa Maria della Misericordia", Azienda Sanitaria Universitaria Friuli Centrale, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.
Cancers (Basel). 2023 Jan 18;15(3):598. doi: 10.3390/cancers15030598.
(1) Background: The treatment of recurrent early glottic cancer (rEGC) remains challenging. We wanted to investigate how the oncological outcomes are affected by the initial and recurrent stages, in order to propose our newly developed Same-Up-Down (SUD) staging system. (2) Methods: In our cohort of 258 rEGC patients, we retrospectively assessed the prognostic performances of the rTNM (the TNM staging system for recurrence), CLRSS, CLRSS-2, and SUD staging systems by univariate and multivariate Cox analysis, comparing their predictive capability using Harrell's C-index. (3) Results: The SUD classification satisfactorily predicted both overall survival ( = 0.022) and second-recurrence-free survival ( = 0.024, as same + down vs. upstage) in our cohort. It also outperformed the other three systems in terms of prediction of survival, with an improvement of 1.52%, 1.18%, and 3.96% in the predictive capacity of overall survival, disease-specific survival, and second-recurrence-free survival, respectively. (4) Conclusions: The SUD staging system can efficiently predict survival in rEGC patients, whose prognosis heavily depends on both the initial and recurrent locoregional extension.
(1) 背景：复发性早期声门癌（rEGC）的治疗仍然具有挑战性。我们想要研究初始阶段和复发阶段如何影响肿瘤学结局，以便提出我们新开发的上下相同（SUD）分期系统。(2) 方法：在我们258例rEGC患者的队列中，我们通过单因素和多因素Cox分析回顾性评估了rTNM（复发的TNM分期系统）、CLRSS、CLRSS - 2和SUD分期系统的预后性能，并使用Harrell氏C指数比较它们的预测能力。(3) 结果：在我们的队列中，SUD分类令人满意地预测了总生存期（P = 0.022）和无第二次复发生存期（P = 0.024，相同 + 向下分期与更高分期相比）。在生存预测方面，它也优于其他三个系统，总生存期、疾病特异性生存期和无第二次复发生存期的预测能力分别提高了1.52%、1.18%和3.96%。(4) 结论：SUD分期系统能够有效地预测rEGC患者的生存期，其预后在很大程度上取决于初始和复发时的局部区域扩展情况。
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