根治性治疗的伴有淋巴结转移的头颈部皮肤鳞状细胞癌远处转移复发的预测因素：一项多中心研究。

Predictors of distant metastatic recurrence in head and neck cutaneous squamous cell carcinoma with lymph node metastases treated with curative intent: A multicenter study.

作者信息

Ebrahimi Ardalan, Gupta Ruta, McDowell Lachlan, Magarey Matthew J R, Smith Paul N, Schulte Klaus-Martin, Perriman Diana M, Veness Michael, Porceddu Sandro, Low Tsu-Hui Hubert, Fowler Allan, Clark Jonathan R

机构信息

Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia.

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

出版信息

Head Neck. 2025 Jan;47(1):254-262. doi: 10.1002/hed.27912. Epub 2024 Aug 9.

DOI:10.1002/hed.27912

PMID:39119874

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11635743/

Abstract

BACKGROUND

We aimed to identify predictors of distant metastatic recurrence (DMR) in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) with nodal metastases treated with curative intent.

METHODS

Predictors of DMR were identified using Cox regression in a multicenter study of 1151 patients.

RESULTS

The 5-year risk of DMR was 9.6%. On multivariate analysis, immunosuppression (HR 2.93; 95% CI: 1.70-5.05; p < 0.001), nodal size >6 cm [versus ≤3 cm (HR 2.77; 95% CI: 1.09-7.03; p = 0.032)], ≥5 nodal metastases [versus 1-2 (HR 2.79; 95% CI: 1.63-4.78; p < 0.001)], and bilateral disease (HR 3.11; 95% CI: 1.40-6.90; p = 0.005) predicted DMR. A DMR risk score was developed that stratified risk from 6.6% (no risk factors) to 100% (≥3 risk factors) (p < 0.001).

CONCLUSIONS

The risk of DMR in nodal metastatic HNcSCC increases with immunosuppression, nodal size >6 cm, ≥5 nodal metastases, and bilateral disease. A simple DMR risk score estimated prior to treatment may be clinically useful.

摘要

背景

我们旨在确定接受根治性治疗的伴有淋巴结转移的头颈部皮肤鳞状细胞癌（HNcSCC）患者远处转移复发（DMR）的预测因素。

方法

在一项对1151例患者的多中心研究中，使用Cox回归确定DMR的预测因素。

结果

DMR的5年风险为9.6%。多因素分析显示，免疫抑制（HR 2.93；95%CI：1.70 - 5.05；p < 0.001）、淋巴结大小>6 cm[对比≤3 cm（HR 2.77；95%CI：1.09 - 7.03；p = 0.032）]、≥5个淋巴结转移[对比1 - 2个（HR 2.79；95%CI：1.63 - 4.78；p < 0.001）]以及双侧病变（HR 3.11；95%CI：1.40 - 6.90；p = 0.005）可预测DMR。制定了一个DMR风险评分，将风险分层为6.6%（无风险因素）至100%（≥3个风险因素）（p < 0.001）。