Comorbidities Predict Poor Prognosis for Advanced Head and Neck Cancer Patients Treated with Major Surgery
Comorbidities Predict Poor Prognosis for Advanced Head and Neck Cancer Patients Treated with Major Surgery
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合并症预示接受大手术治疗的晚期头颈癌患者预后不良
DOI：
10.1002/hed.23897
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Takahiro Asakage
中科院分区：
文献类型：
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作者：
Go Omura;Yuki Saito;Mizuo Ando;Kenya Kobayashi;Tatsuya Yamasoba;Takahiro Asakage
背景合并症对接受大手术治疗的晚期头颈癌患者的影响此前尚未报道。方法我们回顾性审查了我们机构2004年至2011年间的临床图表，并确定了185名接受大手术治疗的临床III期至IV期头颈癌患者。使用成人合并症评估-27（ACE-27）索引手册对合并症进行评分。结果ACE-27 ≥2的患者的总生存期（OS）和疾病特异性生存期（DSS）显著低于ACE-27 ≤1的患者（分别为p< .0001和p = .0047）。多变量分析显示，ACE-27 ≥2和囊外扩散（ECS）是OS和DSS的独立显著不良预后因素。此外，ACE-27 ≥2的患者远处转移的发生率更高（p= .0057）。ConclusionThe当前研究表明，合并症可能预测预后不良和发展的晚期头颈癌患者接受大手术治疗的远处转移。© 2015 Wiley Periodicals，Inc.Head Neck38：364-369，2016
BackgroundThe impact of comorbidities on patients with advanced head and neck cancer treated with major surgery has not been reported before.MethodsWe retrospectively reviewed clinical charts between 2004 and 2011 at our institution and identified 185 patients with clinical stage III to IV head and neck cancer treated with major surgery. Comorbidities were scored using the Adult Comorbidity Evaluation‐27 (ACE‐27) index manual.ResultsPatients with ACE‐27 ≥2 had significantly worse overall survival (OS) and disease‐specific survival (DSS) than those with ACE‐27 ≤1 (p< .0001 andp= .0047, respectively). Multivariate analyses revealed that ACE‐27 ≥2 and extracapsular spread (ECS) were independently significant adverse prognostic factors for OS and DSS. In addition, patients with ACE‐27 ≥2 had a higher incidence of distant metastases (p= .0057).ConclusionThe current study suggests that comorbidities may predict poor prognosis and development of distant metastases for patients with advanced head and neck cancer treated with major surgery. © 2015 Wiley Periodicals, Inc.Head Neck38: 364–369, 2016