Grau J J, Cuchi A, Traserra J, Fírvida J L, Arias C, Blanch J L, Estapé J
Department of Medical Oncology, Hospital Clinic, University of Barcelona, Spain.
Oncology. 1997 Jan-Feb;54(1):38-42. doi: 10.1159/000227659.
The purpose of this clinical study was to analyze a long-term follow-up of all the patients with head and neck cancer in our institution. Between 1973 and 1993, 1,355 consecutive cases of head and neck cancerwere diagnosed, treated and followed up regularly. All were subjected to a multidisciplinary approach, and followed up until death or for 10 years with no event of disease. The local relapse rate was 20% and the node-regional relapse rate 15%. Distant metastases were observed in 6% of the patients mainly arising from the nasopharynx (23%) followed by the hypopharynx (11%). The main organ involved was the lung (50%). Median follow-up of the group was 10 years (range 4 months to 15 years). Cancer cure was observed after 5 years in glottic and supraglottic laryngeal carcinoma, oral and nasopharyngeal cancer and after 2.5 years in patients with cancer of the oropharynx and hypopharynx. The highest cure rate was 80% in the glottis, followed by 70% in the supraglottic area, 45% in the mouth, 30% in the nasopharynx, 25% in the oropharynx, and 20% in the hypopharynx. A second primary tumor was observed in 7% of the patients and a third primary in 0.6% of the patients. Only in 7 patients, the second or third primary was seen after 5 years of follow-up. Curability should be observed after 5 years from definitive therapy of glottic, supraglottic, oral and nasopharyngeal and earlier in oropharyngeal and hypopharyngeal cancer. Further follow-up should be discontinued. Second and third neoplasias are the main problems after 5 years of follow-up but their incidence is low.
本临床研究的目的是分析我院所有头颈癌患者的长期随访情况。1973年至1993年期间，连续诊断、治疗并定期随访了1355例头颈癌病例。所有患者均采用多学科方法治疗，并随访至死亡或随访10年无疾病事件发生。局部复发率为20%，区域淋巴结复发率为15%。6%的患者出现远处转移，主要来自鼻咽癌（23%），其次是下咽癌（11%）。主要受累器官是肺（50%）。该组患者的中位随访时间为10年（范围4个月至15年）。声门型和声门上型喉癌、口腔癌和鼻咽癌患者在5年后观察到癌症治愈，口咽癌和下咽癌患者在2.5年后观察到癌症治愈。治愈率最高的是声门型，为80%，其次是声门上区，为70%，口腔为45%，鼻咽为30%，口咽为25%，下咽为20%。7%的患者观察到第二原发性肿瘤，0.6%的患者观察到第三原发性肿瘤。仅7例患者在随访5年后出现第二或第三原发性肿瘤。声门型、声门上型、口腔和鼻咽癌在确定性治疗5年后应观察到治愈率，口咽癌和下咽癌应更早观察到治愈率。应停止进一步随访。随访5年后，第二和第三原发性肿瘤是主要问题，但其发生率较低。
