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T1a 和 T1b 声门型喉癌患者预后和治疗比较:基于倾向评分匹配 SEER 数据库分析。

Comparison of prognostic and treatment between T1a and T1b glottic cancer: a propensity score-matched SEER database analysis.

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.

Sleep Medicine Centre, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.

出版信息

Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3313-3322. doi: 10.1007/s00405-023-07953-7. Epub 2023 Apr 11.

DOI:10.1007/s00405-023-07953-7
PMID:37039896
Abstract

PURPOSE

The prognoses of T1a and T1b glottic cancers are still controversial. This study aimed to compare the prognosis difference between the two groups based on the population-based Surveillance, Epidemiology, and End Results database (SEER).

METHODS

Data for patients with T1a or T1b glottic cancers were extracted from the SEER database. The bias between T1a and T1b glottic cancers was minimized with Propensity Score Matching (PSM), and disease-specific survival (DSS) was analyzed using the Kaplan-Meier method, log-rank test, and Cox proportional hazards models.

RESULTS

A total of 5,272 patients were extracted from the database, including 847 patients with T1b glottic cancer that were 1:1 propensity score-matched with patients with T1a glottic cancer. After propensity score-matching, there was no statistical difference in disease-specific survival between T1a and T1b patients, whilst survival was impaired by old age. However, on the multivariate analysis, the T1a stage was associated with improved DSS compared with the T1b stage.

CONCLUSION

Our analysis showed that T1a glottic cancers didn't have a significantly better prognosis compared with T1b after PSM. However, the DSS of T1a patients is superior to that of T1b patients in multivariate analysis.

摘要

目的

T1a 和 T1b 声门型癌症的预后仍存在争议。本研究旨在基于基于人群的监测、流行病学和最终结果数据库(SEER)比较两组之间的预后差异。

方法

从 SEER 数据库中提取 T1a 或 T1b 声门型癌症患者的数据。采用倾向评分匹配(PSM)最小化 T1a 和 T1b 声门型癌症之间的偏差,并使用 Kaplan-Meier 方法、对数秩检验和 Cox 比例风险模型分析疾病特异性生存(DSS)。

结果

从数据库中提取了 5272 名患者,其中 847 名 T1b 声门型癌症患者与 T1a 声门型癌症患者进行了 1:1 的倾向评分匹配。在倾向评分匹配后,T1a 和 T1b 患者之间的疾病特异性生存无统计学差异,而年龄较大则会损害生存。然而,在多变量分析中,与 T1b 期相比,T1a 期与改善的 DSS 相关。

结论

我们的分析表明,PSM 后 T1a 声门型癌症的预后并不明显优于 T1b。然而,在多变量分析中,T1a 患者的 DSS 优于 T1b 患者。

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本文引用的文献

1
Prognostic and Treatment Differences Between T1a and T1b Glottic Cancer.声门型 T1a 和 T1b 癌的预后和治疗差异。
Laryngoscope. 2022 Nov;132(11):2187-2193. doi: 10.1002/lary.30030. Epub 2022 Jan 21.
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Prognostic factors in elderly patients with T1 glottic cancer treated with radiotherapy.老年声门型 T1 期喉癌放疗的预后因素
Sci Rep. 2021 Sep 6;11(1):17717. doi: 10.1038/s41598-021-96146-5.
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Long-term Oncologic Outcomes of 1188 Tis-T2 Glottic Cancers Treated by Transoral Laser Microsurgery.经口激光显微手术治疗1188例Tis-T2期声门癌的长期肿瘤学结局
Otolaryngol Head Neck Surg. 2021 Aug;165(2):321-328. doi: 10.1177/0194599820983727. Epub 2021 Jan 5.
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Transoral laser microsurgery for Tis, T1, and T2 glottic carcinoma: 5-year follow-up.经口激光显微手术治疗Tis、T1 和 T2 声门型喉癌:5 年随访结果。
Lasers Med Sci. 2021 Apr;36(3):507-512. doi: 10.1007/s10103-020-03049-4. Epub 2020 May 29.
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Multifactorial analysis of local control and survival in patients with early glottic cancer.多因素分析早期声门型喉癌患者的局部控制和生存情况。
Laryngoscope. 2020 Jul;130(7):1701-1706. doi: 10.1002/lary.28240. Epub 2019 Aug 9.
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Patterns of failure for early-stage glottic carcinoma: 10 years' experience in conformal radiotherapy era.早期声门癌的失败模式:适形放疗时代的10年经验
J Cancer Res Ther. 2019 Jul-Sep;15(3):576-581. doi: 10.4103/jcrt.JCRT_692_17.
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Therapeutic modalities and oncologic outcomes in the treatment of T1b glottic squamous cell carcinoma: a systematic review.T1b期声门型鳞状细胞癌治疗中的治疗方式与肿瘤学结局:一项系统评价
Eur Arch Otorhinolaryngol. 2017 Dec;274(12):4091-4102. doi: 10.1007/s00405-017-4736-z. Epub 2017 Sep 19.
8
Surgical Treatment for Early Stage Glottic Carcinoma with Involvement of the Anterior Commissure.累及前联合的早期声门型喉癌的外科治疗。
Otolaryngol Head Neck Surg. 2018 Feb;158(2):295-302. doi: 10.1177/0194599817728476. Epub 2017 Sep 5.
9
Patterns of Care for Patients With Early-Stage Glottic Cancer Undergoing Definitive Radiation Therapy: A National Cancer Database Analysis.接受根治性放射治疗的早期声门癌患者的护理模式:一项国家癌症数据库分析
Int J Radiat Oncol Biol Phys. 2017 Aug 1;98(5):1014-1021. doi: 10.1016/j.ijrobp.2017.03.050. Epub 2017 Apr 6.
10
T1 squamous cell carcinoma of the glottis with anterior commissure involvement: Radiotherapy versus transoral laser microsurgery.累及前联合的声门T1期鳞状细胞癌:放射治疗与经口激光显微手术的比较
Head Neck. 2017 Jun;39(6):1101-1105. doi: 10.1002/hed.24723. Epub 2017 Mar 28.