Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma
Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma
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DOI：
10.1016/j.oraloncology.2005.01.012
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发表时间：
2005-05-01
期刊：
影响因子：
4.8
通讯作者：
Magrin, J
中科院分区：
文献类型：
--
作者：
Kowalski, LP;Carvalho, AL;Magrin, J
头颈鳞状细胞癌初次治疗后出现远处转移并不被认为是常见事件，并且与不良结果相关。本研究的目的是调查口腔癌和口咽癌患者远处转移诊断的患病率和危险因素。回顾了 1954 年至 1997 年治疗的 2327 名患者的病历。其中 1703 名口腔肿瘤患者（73.2%）和 624 名口咽肿瘤患者（26.8%）。关于主要治疗：637名患者（27.4%）接受了手术； 1147例（49.3%），单独放疗，543例（23.3%），联合治疗（手术和放疗）。在初次治疗后的随访期间，89例患者（3.8%）被诊断为远处转移。与远处无转移生存相关的变量是： 肿瘤部位（p = 0.008）； T 期（p < 0.001）； N 阶段（p < 0.001）；进行的治疗（p < 0.001）和入院十年（p < 0.001）。多变量分析（Cox 回归）显示临床分期（p = 0.007）；进行的治疗（p = 0.012）和入院十年（p = 0.004）是远处转移的独立预测因素。在后十年中，远处转移的诊断更加频繁，与其存在相关的重要预测因素是晚期临床分期和接受联合治疗的患者。 (c) 2005 Elsevier Ltd. 保留所有权利。
The presence of distant metastasis after the initial treatment of head and neck squamous cell carcinoma is not considered a common event and is associated with a poor outcome. The objective of this study was to investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in oral and oropharyngeal carcinoma patients.The medical charts of 2327 patients treated from 1954 to 1997 were reviewed. They were 1703 patients (73.2%) with oral cavity and 624 (26.8%), oropharyngeal tumours. Regarding the primary treatment: 637 patients (27.4%) underwent surgery atone; 1147 (49.3%), radiotherapy atone and 543 (23.3%), combined treatment (surgery and radiotherapy).During the follow-up period after the initial treatment, 89 patients (3.8%) were diagnosed with distant metastasis. The variables associated with the distant metastasis-free survival were: tumour site (p = 0.008); T stage (p < 0.001); N stage (p < 0.001); treatment performed (p < 0.001) and decade of admission at the institution (p < 0.001). The multivariate analysis (Cox regression) showed that the clinical stage (p = 0.007); treatment performed (p = 0.012) and decade of admission at the institution (p = 0.004) were independent predictive factors for distant metastasis.Distant metastasis has been diagnosed more frequently in the latter decade and the significant predictors associated with its presence were the advanced clinical stage and patients who had undergone combined treatment. (c) 2005 Elsevier Ltd. All rights reserved.