多维预后指数作为头颈癌患者死亡率的预测指标：一项队列研究
Multidimensional Prognostic Index as a Predictor of Mortality in Head and Neck Cancer Patients: A Cohort Study.
作者信息
Bakas Ajay T, Sewnaik Aniel, Flikweert Femke, Baatenburg de Jong Robert Jan, Mattace-Raso Francesco, Polinder-Bos Harmke
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC University Cancer Institute, Rotterdam, the Netherlands.
Division of Geriatric Medicine, Department of Internal Medicine, Erasmus MC University Medical Centre, Rotterdam, the Netherlands.
出版信息
Head Neck. 2025 Oct;47(10):2661-2671. doi: 10.1002/hed.28184. Epub 2025 May 6.
BACKGROUND
Head and neck cancer (HNC) significantly impacts older adults, with mortality influenced by multiple factors. The Multidimensional Prognostic Index (MPI), derived from comprehensive geriatric assessment (CGA), may improve risk stratification and clinical decision making.
METHODS
An observational cohort study was conducted at Erasmus Medical Center, Rotterdam, from December 2019 to June 2021. We included 423 HNC patients aged 70 years or older or younger patients with a G8 score of 14 or less. MPI stages were determined through CGA, categorized into stages 1, 2, and 3.
RESULTS
During a median follow-up of 595 days, 115 patients (29%) died. MPI stage 2 and stage 3 were associated with a higher mortality risk compared to MPI stage 1 (HR 2.18; 95% CI 1.46-3.26). In the surgical subgroup, similar mortality risks were observed, but MPI stages did not correlate with postoperative complications.
CONCLUSIONS
MPI stages derived from CGA effectively predict mortality risk in older HNC patients, though they do not predict postoperative complications.
背景
头颈癌（HNC）对老年人有重大影响，死亡率受多种因素影响。源自综合老年评估（CGA）的多维预后指数（MPI）可能会改善风险分层和临床决策。
方法
2019年12月至2021年6月在鹿特丹伊拉斯姆斯医学中心进行了一项观察性队列研究。我们纳入了423例年龄在70岁及以上的头颈癌患者或G8评分在14分及以下的年轻患者。通过CGA确定MPI分期，分为1期、2期和3期。
结果
在中位随访595天期间，115例患者（29%）死亡。与MPI 1期相比，MPI 2期和3期与更高的死亡风险相关（HR 2.18；95%CI 1.46 - 3.26）。在手术亚组中，观察到类似的死亡风险，但MPI分期与术后并发症无关。
结论
源自CGA的MPI分期可有效预测老年头颈癌患者的死亡风险，尽管它们不能预测术后并发症。
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