Subdividing the M1 stage of liver metastasis for nasopharyngeal carcinoma to better predict metastatic survival
Subdividing the M1 stage of liver metastasis for nasopharyngeal carcinoma to better predict metastatic survival
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DOI：
10.1007/s12032-010-9643-8
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发表时间：
2011-12-01
期刊：
影响因子：
3.4
通讯作者：
Wu, Peihong
中科院分区：
文献类型：
--
作者：
Pan, Changchuan;He, Ni;Wu, Peihong
在鼻咽癌（NPC）中，TNM分类的M1期并不区分转移部位或转移病灶的数量。然而，有肺或骨转移的NPC患者比有肝转移（LM）的患者生存时间更长。我们对LM的M1期进行了细分，以更好地预测这些患者的生存率。从2000年1月至2007年12月在中山大学肿瘤防治中心接受治疗的305例NPC伴LM患者的记录中，我们确定了临床特征和LM特征的M1分期子分类[转移的数量、大小、时间（同步与异时）和分布以及转移到其他器官]对自诊断为LM以来生存率的影响。1年转移生存率为62%，2年为31%，3年为21%。有1-3个转移灶、直径小于5 cm的病灶和单小叶LM是转移生存的较好单变量预测因子。1 - 3个（与3个以上）转移性病灶（风险比= 0.52; 95% CI = 0.33-0.82）和单小叶（与双叶）病灶（风险比= 0.35; 95% CI = 0.22-0.57）独立预测生存率更高。目前的报告构成了从我们的单一机构的大型样本的LM鼻咽癌与LM的特点和转移生存之间的相关性。鼻咽癌合并1 ~ 3个肝转移或单小叶转移的患者生存时间较长，应考虑积极治疗。
In nasopharyngeal carcinoma (NPC), the M1 stage of the TNM classification does not differentiate between the site of metastasis or the number of metastatic lesions. However, NPC patients with lung or bone metastases survive longer than do those with liver metastasis (LM). We subdivided the M1 stage of LM to better predict survival in these patients. From the records of 305 NPC patients with LM treated at Sun Yat-sen University Cancer Center between January 2000 and December 2007, we determined the effects of clinical characteristics and the subclassifications of the M1 stage for LM characteristics [the number, size, timing (synchronous vs. metachronous), and distribution of metastases and metastases to other organs] on survival since the diagnosis of LM. Metastatic survival rates were 62% at 1 year, 31% at 2 years, and 21% at 3 years. Having 1-3 metastatic lesions, having lesions less than 5 cm in diameter, and having unilobular LM were better univariate predictors of metastatic survival. Better survival was independently predicted by having one to three (vs. more than three) metastatic lesions (hazards ratio = 0.52; 95% CI = 0.33-0.82) and unilobular (vs. bilobular) lesions (hazards ratio = 0.35; 95% CI = 0.22-0.57). The current report constitutes large samples of LM from NPC from our single institution with correlation between LM characteristics and metastatic survival. Patients with NPC and one to three liver metastases or unilobular metastases survive longer than their counterparts, and aggressive treatment should be considered.