Ildstad S T, Tollerud D J, Bigelow M E, Remensnyder J P
Surgery. 1986 Jan;99(1):7-14.
Little is known about the biologic behavior of squamous cell carcinoma of the head and neck in women. A few recent reports for selected sites have suggested that these tumors may be becoming more common in women. To evaluate potential differences between males and females with squamous cell carcinoma of the oral cavity, oropharynx, and hypopharynx and to assess whether the proportion of females with this disease is increasing, the authors have undertaken a retrospective review of 542 consecutive patients treated at our institution from 1962 through 1976. We report here the first detailed comparison of males and females with squamous cell carcinoma of the head and neck, with attention directed to stage at initial presentation, choice of therapy, response to therapy, age distribution, survival, and prevalence of second primary malignancies. It has been widely published that survival for women with squamous cell carcinoma of the head and neck is superior to that for men, and this has been attributed to a difference in the biologic characteristics of the disease between the two sexes. Although overall survival calculations in our series suggested a significantly better survival rate for women than for men, these rates were strongly influenced by the larger proportion of women (64%) who had stage I or II disease, compared with only 50% of men. When survival was compared stage by stage, there was no significant difference in survival between the two sexes. The proportion of females in the combined study population was 35%, increasing from 33% in the first 5 years of the study period to 40% in the last 5 years. Among patients born before 1920, 34% were female compared with 43% of patients born after 1920. Of the 13 patients less than 40 years of age at diagnosis, 62% were female. The rising proportion of women during the 15-year study period, particularly among young patients and those in more recent birth cohorts, strongly suggests that squamous cell carcinoma of the head and neck is increasing among women in this referral population. A review of the literature indicates that this trend began more than 40 years ago.
关于女性头颈部鳞状细胞癌的生物学行为，人们了解甚少。最近针对特定部位的一些报告表明，这些肿瘤在女性中可能正变得越来越常见。为了评估口腔、口咽和下咽鳞状细胞癌男性与女性之间的潜在差异，并评估患这种疾病的女性比例是否在增加，作者对1962年至1976年在我们机构接受治疗的542例连续患者进行了回顾性研究。我们在此报告头颈部鳞状细胞癌男性与女性的首次详细比较，重点关注初次就诊时的分期、治疗选择、对治疗的反应、年龄分布、生存率以及第二原发性恶性肿瘤的患病率。已有广泛报道称，头颈部鳞状细胞癌女性的生存率高于男性，这归因于两性之间该疾病生物学特征的差异。尽管我们系列研究中的总体生存计算表明女性的生存率明显高于男性，但这些比率受到女性中I期或II期疾病患者比例较大（64%）的强烈影响，而男性中这一比例仅为50%。当按阶段比较生存率时，两性之间的生存率没有显著差异。在综合研究人群中女性的比例为35%，从研究期的前5年的33%增加到最后5年的40%。在1920年以前出生的患者中，34%为女性，而1920年以后出生的患者中这一比例为43%。在诊断时年龄小于40岁的13例患者中，62%为女性。在15年的研究期内女性比例不断上升，特别是在年轻患者和较近出生队列的患者中，这有力地表明在这个转诊人群中头颈部鳞状细胞癌在女性中正在增加。文献综述表明，这一趋势始于40多年前。
