Hoffman H T, Karnell L H, Funk G F, Robinson R A, Menck H R
Department of Otolaryngology--Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, USA.
Arch Otolaryngol Head Neck Surg. 1998 Sep;124(9):951-62. doi: 10.1001/archotol.124.9.951.
The National Cancer Data Base (NCDB), a large sample of cancer cases accrued from hospital-based cancer registries, is sponsored by the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The NCDB permits a detailed analysis of case-mix, treatment, and outcome variables.
To provide an overview of the contemporary status of the subset of patients with head and neck cancer in the United States.
The NCDB, which obtains data from US as well as Canadian and Puerto Rican hospitals, accrued 4 583 455 cases of cancer between 1985 and 1994. Of these cases, 301350 (6.6%) originated in the head and neck. We address 295022 cases of head and neck cancer limited to the 50 United States and District of Columbia. Cases were segregated into an earlier group (1985-1989) to permit 5-year follow-up and into a later group (1990-1994) to analyze a more contemporary group. Comparison between both periods permits identification of trends.
The largest proportion of cases arose in the larynx (20.9%) and oral cavity, including lip (17.6%) and thyroid gland (15.8%). Squamous cell carcinoma (55.8%) was the most common histological finding, followed by adenocarcinoma (19.4%) and lymphoma (15.1%). Income level (low), race (African American), and tumor grade (poorly differentiated) were most notably associated with advanced stage. Treatment was most commonly surgery alone (32.4%), combined surgery with irradiation (25.0%), and irradiation alone (18.9%). Overall 5-year, disease-specific survival was 64.0%. Cancer of the lip demonstrated the best survival (91.1%) and cancer of the hypopharynx the worst survival (31.4%).
This NCDB analysis of cancer of the head and neck provides a contemporary overview of head and neck cancer in the United States. It also serves to introduce a series of NCDB articles that address specific anatomical sites and histological types through separate, detailed analysis.
国家癌症数据库（NCDB）是一个从医院癌症登记处收集的大量癌症病例样本，由美国外科医师学会癌症委员会和美国癌症协会赞助。NCDB允许对病例组合、治疗和结果变量进行详细分析。
概述美国头颈癌患者亚组的当代状况。
NCDB从美国以及加拿大和波多黎各的医院获取数据，在1985年至1994年间收集了4583455例癌症病例。其中，301350例（6.6%）起源于头颈部。我们研究了仅限于美国50个州和哥伦比亚特区的295022例头颈癌病例。病例被分为早期组（1985 - 1989年）以便进行5年随访，以及后期组（1990 - 1994年）以分析更当代的一组。两个时期之间的比较有助于确定趋势。
病例中比例最大的发生在喉（20.9%）、口腔（包括唇，17.6%）和甲状腺（15.8%）。鳞状细胞癌（55.8%）是最常见的组织学发现，其次是腺癌（19.4%）和淋巴瘤（15.1%）。收入水平（低）、种族（非裔美国人）和肿瘤分级（低分化）与晚期最为显著相关。最常见的治疗方式是单纯手术（32.4%）、手术联合放疗（25.0%）和单纯放疗（18.9%）。总体5年疾病特异性生存率为64.0%。唇癌的生存率最高（91.1%），下咽癌的生存率最低（31.4%）。
NCDB对头颈癌的分析提供了美国头颈癌的当代概述。它还用于介绍一系列通过单独、详细分析探讨特定解剖部位和组织学类型的NCDB文章。
