Dong Jun, Zhu Zhengqiu
Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, China.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):2115-2124. doi: 10.1007/s00405-024-09146-2. Epub 2024 Dec 16.
This study aimed to examine the effect of elective neck dissection (END) on the prognosis of patients with cT3/T4N0 maxillary sinus squamous cell carcinoma (MSSCC).
Data were obtained from the SEER database. Patients with cT3/T4a/T4bN0 MSSCC were included in the study and divided into two groups: those who received END treatment and those who did not. Differences between the two groups were assessed using propensity score matching. Cox regression was used to screen patients for independent risk factors. The effect of END on cancer-specific survival (CSS) and overall survival (OS) was explored, and subgroup analyses were performed.
A total of 327 patients with cT3/T4N0 MSSCC were enrolled. After propensity score matching (PSM), patients treated with END showed significant improvement in overall survival (OS) and cancer-specific survival (CSS) compared with those who did not receive END (P < 0.05). In subgroup analyses, the hazard ratio was 0.729 (95% confidence interval: 0.549-0.967), indicating a favourable prognosis for patients receiving END. Certain subgroups of patients benefited significantly from END. These subgroups included patients older than 65 years, Caucasian, male, not receiving radiotherapy, stage T3, grade II and MSSCC with a tumour size of 3-5 cm.
END improves survival time and survival outcomes in patients with cT3/T4a/T4bN0 MSSCC, especially in cT3 patients.
本研究旨在探讨择期颈部清扫术（END）对cT3/T4N0上颌窦鳞状细胞癌（MSSCC）患者预后的影响。
数据来源于监测、流行病学和最终结果（SEER）数据库。纳入cT3/T4a/T4bN0 MSSCC患者并分为两组：接受END治疗的患者和未接受END治疗的患者。使用倾向评分匹配评估两组之间的差异。采用Cox回归筛选患者的独立危险因素。探讨END对癌症特异性生存（CSS）和总生存（OS）的影响，并进行亚组分析。
共纳入327例cT3/T4N0 MSSCC患者。倾向评分匹配（PSM）后，接受END治疗的患者与未接受END治疗的患者相比，总生存（OS）和癌症特异性生存（CSS）有显著改善（P < 0.05）。在亚组分析中，风险比为0.729（95%置信区间：0.549 - 0.967），表明接受END治疗的患者预后良好。某些亚组患者从END中显著获益。这些亚组包括年龄大于65岁、白种人、男性、未接受放疗、T3期、II级以及肿瘤大小为3 - 5 cm的MSSCC患者。
END可改善cT3/T4a/T4bN0 MSSCC患者的生存时间和生存结局，尤其是cT3患者。
