Treatment and survival in 10,429 patients with localized laryngeal cancer: a population-based analysis.
Treatment and survival in 10,429 patients with localized laryngeal cancer: a population-based analysis.
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DOI：
10.1002/cncr.28608
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发表时间：
2014-06-15
期刊：
影响因子：
6.2
通讯作者：
Virnig BA
中科院分区：
文献类型：
--
作者：
Misono S;Marmor S;Yueh B;Virnig BA
本研究的目的是确定与治疗差异相关的因素，描述治疗模式随时间变化的特征，并比较接受局限性喉癌治疗的患者不同治疗类型的生存率。利用监测、流行病学和最终结果数据库，我们对 1995 年至 2009 年接受局部喉癌治疗的患者进行了回顾性队列分析。定义了四个治疗组：（1）仅放疗，（2）仅局部手术，（3）局部手术和放疗，以及（4）开放手术加或不加放疗。根据人口统计学因素评估这些组之间治疗率的差异，并计算治疗率随时间的差异。使用 Kaplan-Meier 方法评估治疗与死亡率之间的关联。 Cox 比例风险回归模型用于调整潜在的混杂协变量。总共确定了 10,429 名局限性喉癌患者。大多数患者（57%）仅接受放射治疗； 25% 接受局部手术和放射治疗，9% 只接受局部手术，9% 接受开放手术加或不加放射治疗。种族、年龄和登记与治疗差异相关。在研究期间，接受单一模式治疗的人数增加，接受联合模式治疗的人数减少。白种人、年龄较小和局部手术治疗的生存率更高。在诊断后 3 年内观察到与治疗类型相关的生存差异，并在诊断后持续 5 年以上。尽管随着时间的推移，治疗模式变得更加符合治疗指南，但我们发现了与治疗类型相关的生存差异，需要进一步研究局部喉癌患者的治疗决策。
The objectives of this study were to identify factors associated with treatment differences, characterize changes in treatment patterns over time, and compare survival across treatment types in patients who received treatment for localized laryngeal cancer. Using the Surveillance, Epidemiology, and End Results database, we conducted a retrospective cohort analysis of patients who were treated from 1995 to 2009 for localized laryngeal cancer. Four treatment groups were defined: (1) radiation only, (2) local surgery only, (3) local surgery and radiation, and (4) open surgery with or without radiation. Variations in treatment rates between these groups were evaluated according to demographic factors, and differences in treatment rates across time were calculated. Associations between treatment and mortality were assessed using Kaplan-Meier methods. Cox proportional hazards regression models were used to adjust for potential confounding covariates. In total, 10,429 patients with localized laryngeal cancer were identified. Most patients (57%) were treated with radiation only; 25% with local surgery and radiation, 9% with local surgery only, and 9% with open surgery with or without radiation. Race, age, and registry were associated with differences in treatment. Receipt of single-modality treatment increased and receipt of combined-modality treatment decreased over the study period. Better survival was observed with white race, younger age, and treatment with local surgery. Survival differences associated with treatment type were observed within 3 years of diagnosis and persisted beyond 5 years after diagnosis. Although treatment patterns became more adherent to treatment guidelines over time, we identified survival differences associated with treatment type that warrant further investigation into treatment decision-making for patients with localized laryngeal cancer.
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DOI：
10.1002/hed.10361
发表时间：
2004-02-01
影响因子：
2.9
作者：
Jones, AS;Fish, B;Husband, DJ
通讯作者：
Husband, DJ
影响因子：
2.6
作者：
Higgins, Kevin M.
通讯作者：
Higgins, Kevin M.
影响因子：
2.6
作者：
Nichols, Anthony C.;Bhattacharyya, Neil
通讯作者：
Bhattacharyya, Neil
影响因子：
1.4
作者：
Brandenburg, JH
通讯作者：
Brandenburg, JH
影响因子：
3.4
作者：
Higgins, Kevin M.;Shah, Manish D.;Enepekides, Danny
通讯作者：
Enepekides, Danny