Li Yujiao, Hu Chaosu
Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Cancer Hospital, Shanghai, China.
Shanghai Key Laboratory of Radiation Oncology (20dz2261000), Shanghai, China.
Ear Nose Throat J. 2023 Nov 22:1455613231212052. doi: 10.1177/01455613231212052.
The objective of this study is to assess the risk factors for synchronous lung metastases (LM) in patients with hypopharynx squamous cell carcinomas (HPSCC). HPSCC patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2013. We examined the association between risk factors and synchronous LM using chi-squared tests. Predictors of survival rates were assessed using univariate and multivariate analyses. A total of 1683 patients were analyzed, including 70 patients (4.2%) with synchronous LM, and 1613 patients without synchronous LM (95.8%). Multivariate logistic regression analysis showed that Caucasian ( = .038), lower T ( = .026) or N classification ( = .000), and highly differentiated disease ( = .002) were associated with a significantly lower risk of LM. Elderly not married patients with higher T or N classification, multiple sites of metastases, and no surgical therapy to the primary tumors were more likely to reduce life expectancy. By analyzing data from a large cohort, Caucasian, lower T or N classification, and highly differentiated disease were associated with a significantly lower risk of LM. Elderly not married patients with advanced T or N classification, no surgical therapy to the primary tumors, and multiple sites of metastases were more likely to reduce life expectancy. More accurate assessments of LM will be imperative for early diagnosis and treatment in non-Caucasian patients who harbored higher T or N classification and poorly differentiated disease.
本研究的目的是评估下咽鳞状细胞癌（HPSCC）患者发生同步肺转移（LM）的风险因素。2010年至2013年期间从监测、流行病学和最终结果（SEER）数据库中提取HPSCC患者。我们使用卡方检验研究风险因素与同步LM之间的关联。使用单因素和多因素分析评估生存率的预测因素。总共分析了1683例患者，其中包括70例（4.2%）发生同步LM的患者和1613例未发生同步LM的患者（95.8%）。多因素逻辑回归分析显示，白种人（P = 0.038）、较低的T（P = 0.026）或N分级（P = 0.000）以及高分化疾病（P = 0.002）与LM风险显著降低相关。年龄较大且未婚、T或N分级较高、存在多处转移且未对原发性肿瘤进行手术治疗的患者更有可能缩短预期寿命。通过分析来自大型队列的数据，白种人、较低的T或N分级以及高分化疾病与LM风险显著降低相关。年龄较大且未婚、T或N分级较高、未对原发性肿瘤进行手术治疗且存在多处转移的患者更有可能缩短预期寿命。对于T或N分级较高且疾病分化较差的非白种人患者，更准确地评估LM对于早期诊断和治疗至关重要。
