与放化疗相比，T4aM0 下咽鳞癌行全咽环周切除术的生存结局优势：日本全国数据库研究。
Survival Outcome Superiority of Total Pharyngolaryngectomy Compared with Chemoradiotherapy for T4aM0 Hypopharyngeal Squamous Cell Carcinoma: A Nationwide Database Study of Japan.
机构信息
Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan.
The Japan Society for Head and Neck Cancer, Tokyo, Japan.
出版信息
Ann Surg Oncol. 2024 Nov;31(12):8206-8213. doi: 10.1245/s10434-024-15994-3. Epub 2024 Aug 12.
BACKGROUND
The purpose of this study is to elucidate whether total pharyngolaryngectomy (TPL) or chemoradiotherapy (CRT) provides a better prognostic outcome in patients with T4aM0 hypopharyngeal carcinoma (HPSCC) using a nationwide database.
METHODS
All data were obtained from the Head and Neck Cancer Registry of Japan, and information from patients who were newly diagnosed with T4aM0 HPSCC between 2011 and 2015 was extracted. The primary endpoint was disease-specific survival (DSS), and the secondary endpoint was overall survival (OS). The inverse probability of treatment weighting (IPTW) adjustments was used for survival analyses.
RESULTS
Our cohort included 1143 patients. The TPL and CRT groups included 724 and 419 patients, respectively. Following IPTW adjustments, both the OS and DSS of the TPL group were significantly longer than those of the CRT group (P = .02 and P = .002, respectively).
CONCLUSIONS
Survival superiority was demonstrated for patients with T4aM0 HPSCC treated with TPL compared with those treated with CRT.
背景
本研究旨在利用全国性数据库阐明全咽环喉切除术（TPL）与放化疗（CRT）在 T4aM0 下咽鳞癌（HPSCC）患者中的预后结果。
方法
所有数据均来自日本头颈部癌症注册处，提取了 2011 年至 2015 年间新诊断为 T4aM0 HPSCC 的患者信息。主要终点是疾病特异性生存（DSS），次要终点是总生存（OS）。采用逆概率治疗加权（IPTW）调整进行生存分析。
结果
本队列纳入 1143 例患者。TPL 组和 CRT 组分别纳入 724 例和 419 例患者。经 IPTW 调整后，TPL 组的 OS 和 DSS 均显著长于 CRT 组（P=0.02 和 P=0.002）。
结论
与 CRT 相比，T4aM0 HPSCC 患者接受 TPL 治疗的生存优势更为显著。
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