以淋巴血管侵犯为唯一不良病理特征的 HPV 阳性口咽鳞癌中辅助放疗与生存的相关性。
Association of adjuvant radiation and survival in human papilloma virus-positive oropharynx squamous cell carcinoma with lymphovascular invasion as the sole adverse pathologic feature.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Saint Louis University, St. Louis, Missouri, USA.
Saint Louis University School of Medicine, St. Louis, Missouri, USA.
出版信息
Head Neck. 2024 May;46(5):1043-1050. doi: 10.1002/hed.27740. Epub 2024 Mar 21.
BACKGROUND
Postoperative radiotherapy radiation therapy (PORT) for early-stage human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) with positive lymphovascular invasion (LVI) has an unclear association with overall survival (OS).
METHODS
This retrospective cohort study queried the National Cancer Database for surgically treated, T1-2, N0-1 HPV+ OPSCC from 2010 to 2019. Primary exposures were LVI and PORT, and the main outcome was 5-year OS. Odds ratios and hazard ratios (HR) with 95% confidence intervals (CIs) were generated using multivariable models and Cox proportional hazard models, respectively.
RESULTS
Of 2768 patients, average age was 59.3 years, 2207 (79.7%) were male, and 386 (13.9%) had LVI. Of patients with LVI as their sole adverse pathologic feature, 220 (57.0%) received PORT, which was not associated with 5-year OS (HR, 1.13; CI, 0.65-1.19).
CONCLUSIONS
Patients with surgically treated, early-stage HPV+ OPSCC and positive LVI as their only pathologic adverse feature may not require PORT.
背景
对于伴有阳性淋巴血管侵犯（LVI）的早期人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌（OPSCC）患者，术后放疗（PORT）与总生存期（OS）的相关性尚不清楚。
方法
本回顾性队列研究从 2010 年至 2019 年，从国家癌症数据库中查询了接受手术治疗的 T1-2、N0-1HPV+OPSCC 患者。主要暴露因素为 LVI 和 PORT，主要结局为 5 年 OS。使用多变量模型和 Cox 比例风险模型分别生成了比值比（OR）和风险比（HR）及其 95%置信区间（CI）。
结果
在 2768 例患者中，平均年龄为 59.3 岁，2207 例（79.7%）为男性，386 例（13.9%）有 LVI。在仅有 LVI 作为唯一不良病理特征的患者中，220 例（57.0%）接受了 PORT，但与 5 年 OS 无关（HR，1.13；CI，0.65-1.19）。
结论
对于仅具有 LVI 这一唯一不良病理特征的接受手术治疗的早期 HPV+OPSCC 患者，可能不需要 PORT。
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