Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer.
Prognostic Impact of Metastatic Site and Pattern in Patients with Metastatic Head and Neck Cancer.
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DOI：
10.1002/lary.29208
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Jorgensen JB
中科院分区：
文献类型：
--
作者：
Bollig CA;Newberry CI;Galloway TLI;Zitsch RP;Hanly EK;Zhu VL;Pagedar N;Nallani R;Bur AM;Spanos WC;Jorgensen JB
在一个多机构队列中研究远端转移（DM）的部位和模式与DM头颈癌（HNC）患者总生存期（OS）之间的关系。回顾性审查。对2000年至2015年期间在中西部HNC联盟的4个学术中心接受治疗的283例患者进行了回顾性分析。疾病模式分为单发转移性与多发转移性（≥2个部位）疾病。使用Kaplan-Meier和考克斯比例风险模型估计临床相关变量的生存函数。所有患者的中位OS为9.0个月（95%置信区间[CI]：7.4-10.6）。肺（n = 220，77.7%）是DM最常见的部位，其次是骨（n = 90，31.8%）、纵隔淋巴结（n = 55，19.4%）、肝脏（n = 41，14.5%）和脑（n = 17，6.0%）。骨转移与最差预后独立相关（风险比[HR] = 1.6，95% CI：1.3-2.1）。在单变量分析中，脑转移与预后改善相关（HR = 0.5，95%CI：0.3-0.9），尽管在多变量分析中没有统计学意义。大多数患者（n = 230，81.3%）存在多转移性疾病，与孤立性转移性疾病相比，预后较差（HR = 1.4，95% CI：1.0-2.0）。我们的大型多机构综述表明，DM的转移模式和部位均影响OS。多发性转移性疾病和骨转移与预后不良相关，与接受的治疗无关。
Investigate the relationship between site and pattern of distant metastasis (DM) and overall survival (OS) in a multi-institutional cohort of patients with DM head and neck cancer (HNC). Retrospective review. 283 patients treated at 4 academic centers in the Midwest HNC Consortium between 2000 and 2015 were retrospectively reviewed. Disease patterns were divided between solitary metastatic versus polymetastatic (≥2 sites) disease. Survival functions for clinically relevant variables were estimated using Kaplan-Meier and Cox proportional hazards models. Median OS for all patients was 9.0 months (95% confidence interval [CI]: 7.4–10.6). Lung (n = 220, 77.7%) was the most common site of DM, followed by bone (n = 90, 31.8%), mediastinal lymph nodes (n = 55, 19.4%), liver (n = 41, 14.5%), and brain (n = 17, 6.0%). Bone metastases were independently associated with the worst prognosis (hazard ratio [HR] = 1.6, 95% CI: 1.3–2.1). On univariate analysis, brain metastases were associated with improved prognosis (HR = 0.5, 95% CI: 0.3–0.9), although this was not statistically significant on the multivariate analysis. Polymetastatic disease was present in the majority of patients (n = 230, 81.3%) and was associated with a worse prognosis compared to solitary metastatic disease (HR = 1.4, 95% CI: 1.0–2.0). Our large, multi-institutional review indicates that both the metastatic pattern and site of DM impact OS. Polymetastatic disease and bone metastasis are associated with worse prognosis, independent of treatment received.
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影响因子：
3.1
作者：
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