Factors affecting survival in maxillary sinus cancer
Factors affecting survival in maxillary sinus cancer
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DOI：
10.1016/s0278-2391(03)00313-6
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发表时间：
2003-09-01
影响因子：
1.9
通讯作者：
Bhattacharyya, N
中科院分区：
文献类型：
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作者：
Bhattacharyya, N
目的：确定上颌窦恶性肿瘤患者的生存参数和影响生存的临床因素。方法：从监测、流行病学和结局数据库中提取1988~1998年间的上颌窦恶性肿瘤病例。排除了表现时有远处转移的病例。临床资料，包括肿瘤组织学，分级和分期，手术和放射治疗的程度。采用Kaplan-Meier生存分析和COX比例风险分析，确定这些因素对总生存的影响。结果：研究样本包括650例上颌窦癌患者(平均年龄，男女之比3：2)。最常见的组织学类型是鳞状细胞癌(61.7%)，其次是腺样囊性癌(9.8%)。中位生存期为52个月(25个月)，晚期(T3/T4)和颈部转移患者分别占77.5%和7.4%。441名患者(67.9%)接受了放射治疗，显著提高了存活率，主要是那些有T4病变的患者。在多变量分析中，年龄、T分期、N分期和肿瘤分级的增加独立地预测较差的生存，而性别不是。腺样囊性癌患者的总体生存率显著提高(P<；.001)。结论：上颌窦癌患者的生存率不仅取决于TNM分期，还取决于肿瘤的组织学和分级。TNM分期有效地根据生存情况对患者进行分层。放射治疗显著提高了T4病变患者的存活率。2003年美国口腔颌面外科医生协会。
Purpose: The study goal was to determine survival parameters and clinical factors influencing survival for maxillary sinus malignancies.Methods: Cases of maxillary sinus malignancy for the time period 1988 to 1998 were extracted from the Surveillance, Epidemiology and End Results database. Cases with distant metastatic disease at presentation were excluded. Clinical information, including tumor histology, grade and stage, and extent of surgery and radiation therapy, were determined. Kaplan-Meier survival and Cox proportional hazards analyses were conducted to determine the influence of these factors on overall survival.Results: The study sample was composed of 650 patients with maxillary sinus cancer (mean age, 64 years; male-to-female ratio, 3:2). The most common histology was squamous cell carcinoma (61.7%), followed by adenoid cystic carcinoma (9.8%). The overall mean (median) survival was 52 months (25 months), and 77.5% and 7.4% of patients presented with advanced (T3/T4) disease or cervical metastasis, respectively. Radiation therapy was administered in 441 patients (67.9%) and significantly improved survival mainly for those with T4 lesions. On multivariate analysis, increasing age, T stage, N stage, and tumor grade independently predicted poorer survival, whereas gender did not. Adenoid cystic carcinoma exhibited a significantly improved overall survival (P < .001).Conclusions: Survival for patients with maxillary sinus cancer is determined not only by TNM staging but also by tumor histology and grade. TNM staging effectively stratifies patients according to survival. Radiation therapy significantly improves survival for those with T4 lesions. 2003 American Association of Oral and Maxillofacial Surgeons.