Wang Li, Wang Jie, Wang Tian, Li Yi, Song Xinmao
Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, China.
Department of Oncology, 920th Hospital of Joint Logistics Support Force, 212 Daguan Road, Kunming 650032, China.
Ther Adv Med Oncol. 2024 Nov 16;16:17588359241299331. doi: 10.1177/17588359241299331. eCollection 2024.
Due to the rarity of sinonasal squamous cell carcinoma (SNSCC), the distribution patterns of lymph node metastasis (LNM), the relationship between LNM and prognosis, and the optimal treatment of LNM lack sufficient evidence-based support.
To investigate the patterns of LNM in SNSCC and evaluate the impact of LNM on prognosis.
This was a retrospective cohort study.
The medical records of 441 patients with SNSCC between 2009 and 2022 in one institution were retrospectively reviewed. We assessed the incidence, the distribution of LNM, and the relationship between LNM and long-term survival.
Seventy-three out of 441 patients (16.6%) presented LNM initially. Among the 73 patients, 34 patients (46.6%) had LNM in the region of ipsilateral level II; 22 patients (30.1%) had positive retropharyngeal lymph nodes; 20 patients (27.4%) had LNM in the region of ipsilateral level Ib; and nine patients (12.3%) had evidence of parotid LNM. Poor differentiation ( = 0.001), nasal cavity ( = 0.018), skin involvement ( = 0.036), and nasopharynx involvement ( = 0.009) were the risk factors for LNM. In the univariate and multivariate analyses, the overall survival ( = 0.25), progression-free survival ( = 0.22), regional failure-free survival ( = 0.20), and distant metastasis-free survival ( = 0.14) rates were not significantly decreased by the LNM. After the propensity score matching, LNM was still not correlated with poor long-term survival.
The incidence of retropharyngeal and parotid LNM was higher than in previous studies. At initial diagnosis, the risk factors for LNM were identified, and LNM was not associated with poor survival outcomes.
由于鼻窦鳞状细胞癌（SNSCC）罕见，淋巴结转移（LNM）的分布模式、LNM与预后的关系以及LNM的最佳治疗方法缺乏充分的循证支持。
研究SNSCC中LNM的模式，并评估LNM对预后的影响。
这是一项回顾性队列研究。
回顾性分析了一家机构2009年至2022年间441例SNSCC患者的病历。我们评估了LNM的发生率、分布情况以及LNM与长期生存的关系。
441例患者中有73例（16.6%）初诊时出现LNM。在这73例患者中，34例（46.6%）在同侧Ⅱ区有LNM；22例（30.1%）咽后淋巴结阳性；20例（27.4%）在同侧Ib区有LNM；9例（12.3%）有腮腺LNM证据。低分化（P = 0.001）、鼻腔受累（P = 0.018）、皮肤受累（P = 0.036）和鼻咽受累（P = 0.009）是LNM的危险因素。在单因素和多因素分析中，LNM并未使总生存（P = 0.25）、无进展生存（P = 0.22）、区域无复发生存（P = 0.20）和远处无转移生存（P = 0.14）率显著降低。倾向评分匹配后，LNM仍与不良长期生存无关。
咽后和腮腺LNM的发生率高于既往研究。在初诊时确定了LNM的危险因素，且LNM与不良生存结局无关。
