基于美国癌症联合委员会分期和 T、N 整数评分的喉癌非手术治疗预后。

Non-Surgical Treatment Prognosis For Laryngeal Cancer Based On American Joint Committee On Cancer Staging And T And N Integer Score.

机构信息

Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran.

Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

J Ayub Med Coll Abbottabad. 2023 Jul-Sep;35(3):361-366. doi: 10.55519/JAMC-03-11523.

DOI:10.55519/JAMC-03-11523

PMID:38404072

Abstract

BACKGROUND

The American Joint Committee on Cancer (AJCC) system is the most acceptable staging method. In this study, an attempt has been made to evaluate the survival rate of laryngeal cancer based on the AJCC and T and N integer scores (TANIS).

METHODS

In this prospective cohort study, from March 2004 to March 2021, laryngeal cancer patients who were considered for non-surgical treatment were included. Radiation alone was considered for T1-T2 lesions without nodal involvement. Sequential or concomitant chemoradiation (based on physician choice) was considered for locoregionally advanced patients (T3/T4 or node positive). The 2-year, 5-year and 10-year overall survival (OS) and progression-free survival (PFS) rates were estimated using Kaplan-Meier method. Cox -Regression method was used for covariates analysis.

RESULTS

The 2-year, 5-year and 10-year overall survival (OS) rates in all patients were estimated to be 82%, 70% and 41%, respectively. The 2-year, 5-year and 10-year progression-free survival (PFS) rates in all patients were estimated to be 78%, 59% and 41%, respectively. The 5-year OS rates for stages I, II, III, IVa, and IVb were 83, 84, 51, 12, and 19 percent, respectively. The 5-year OS rates for TANIS 1, 2, and 3 were 85, 62 and 53 percent, respectively. Based on multivariate analysis, the group stage (p=0.001), TANIS group (p=0.003) and tumour subsite. (p=0.006) were independently effective in survival rates.

CONCLUSION

TANIS-3 can simply predict the prognosis of non-surgically treated laryngeal cancers. The separation of different prognostic groups by TANIS is better than the AJCC system. More extensive studies are necessary to confirm this.

摘要

背景

美国癌症联合委员会（AJCC）系统是最被认可的分期方法。本研究尝试基于 AJCC 和 T、N 整数评分（TANIS）评估喉癌的生存率。

方法

本前瞻性队列研究纳入了 2004 年 3 月至 2021 年 3 月期间考虑非手术治疗的喉癌患者。对于无淋巴结受累的 T1-T2 病变，仅考虑放疗。局部进展期患者（T3/T4 或淋巴结阳性）则考虑序贯或同期放化疗（基于医生选择）。采用 Kaplan-Meier 法估计 2 年、5 年和 10 年总生存率（OS）和无进展生存率（PFS）。采用 Cox 回归法进行协变量分析。

结果

所有患者的 2 年、5 年和 10 年 OS 率估计分别为 82%、70%和 41%。所有患者的 2 年、5 年和 10 年 PFS 率估计分别为 78%、59%和 41%。Ⅰ、Ⅱ、Ⅲ、Ⅳa 和Ⅳb 期患者的 5 年 OS 率分别为 83%、84%、51%、12%和 19%。TANIS 1、2 和 3 组患者的 5 年 OS 率分别为 85%、62%和 53%。多因素分析显示，分期（p=0.001）、TANIS 组（p=0.003）和肿瘤部位（p=0.006）是影响生存率的独立因素。