Yücel Levent, Yücel Kadriye Bir, Başak Hazan, Beton Süha, Büyükatalay Zahide Çiler
Department of Otorhinolaryngology, University of Health Sciences, Gülhane Training and Research Hospital, General Dr. Tevfik Sağlam Street, No:1, Etlik/Ankara, 06010 Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, University of Ankara, Ankara, Turkey.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3161-3175. doi: 10.1007/s12070-023-03934-8. Epub 2023 Jun 14.
The literature focuses primarily on laryngeal differentiated squamous cell carcinoma (SCC), and only a limited number of studies have evaluated the outcomes of rare variants of SCC (vSCC) and non-SCC malignancies (nSCC). To our knowledge, this is the first study to compare the survival outcomes of these two groups. We retrospectively reviewed the records of 816 patients who underwent laryngeal surgery from January 2010 to November 2022. Forty-nine (6.2%) were identified as having unusual larynx malignancies and categorized in the nSCC or vSCC groups. The patients' clinicopathological features were then recorded. We compared the two groups' overall survival (OS) and recurrence-free survival (RFS) outcomes. Thirty-three (4.2%) patients had vSCC, and 16 (2%) had nSCC. Forty-two (85.7%) were male, and the mean age was 58.57 years. The median follow-up time was 69 months. The 5-year OS rate was 71.4% in the nSCC group vs. 87.9% in the vSCC group ( = .055). Only surgical margin (HR: 4.68; 95% CI:1.13-19.37, = .033) was an independent prognostic factor for OS in the multivariable analysis. The 5-year RFS rate was 50% for the nSCC group compared to 90.9% for the vSCC group ( < .001). In the multivariable analysis, surgical margin positivity (HR: 21.0, 95% CI 3.97-98.1, < .001), and lymphovascular invasion (HR: 0.043, 95% CI 0.005-0.357, = .004) were independent prognostic factors for RFS. Although OS did not show a statistical difference, nSCC malignancies of the larynx demonstrated worse OS and RFS outcomes than vSCC malignancies.
The online version contains supplementary material available at 10.1007/s12070-023-03934-8.
文献主要聚焦于喉分化型鳞状细胞癌(SCC),仅有有限数量的研究评估了SCC罕见变体(vSCC)和非SCC恶性肿瘤(nSCC)的预后。据我们所知,这是第一项比较这两组生存预后的研究。我们回顾性分析了2010年1月至2022年11月期间接受喉手术的816例患者的记录。49例(6.2%)被确定患有不寻常的喉恶性肿瘤,并归类于nSCC或vSCC组。然后记录患者的临床病理特征。我们比较了两组的总生存(OS)和无复发生存(RFS)预后。33例(4.2%)患者为vSCC,16例(2%)为nSCC。42例(85.7%)为男性,平均年龄为58.57岁。中位随访时间为69个月。nSCC组的5年OS率为71.4%,vSCC组为87.9%(P = 0.055)。在多变量分析中,仅手术切缘(HR:4.68;95%CI:1.13 - 19.37,P = 0.033)是OS的独立预后因素。nSCC组的5年RFS率为50%,vSCC组为90.9%(P < 0.001)。在多变量分析中,手术切缘阳性(HR:21.0,95%CI 3.97 - 98.1,P < 0.001)和脉管侵犯(HR:0.043,95%CI 0.005 - 0.357,P = 0.004)是RFS的独立预后因素。尽管OS未显示统计学差异,但喉nSCC恶性肿瘤的OS和RFS预后比vSCC恶性肿瘤更差。
在线版本包含可在10.1007/s12070 - 023 - 03934 - 8获取的补充材料。