Predictors of survival after total laryngectomy for recurrent/persistent laryngeal squamous cell carcinoma.
Predictors of survival after total laryngectomy for recurrent/persistent laryngeal squamous cell carcinoma.
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DOI：
10.1002/hed.24918
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发表时间：
2017-12
期刊：
影响因子：
--
通讯作者：
Spector ME
中科院分区：
文献类型：
--
作者：
Birkeland AC;Beesley L;Bellile E;Rosko AJ;Hoesli R;Chinn SB;Shuman AG;Prince ME;Wolf GT;Bradford CR;Brenner JC;Spector ME
全喉切除术仍然是放疗（RT）或放化疗（CRT）后复发/持续性喉鳞状细胞癌（LSCC）的治疗选择。然而，尽管尝试积极的手术挽救，在这个队列中的生存率仍然不理想。对1998年至2015年期间在初始RT/CRT后因复发性/持续性LSCC接受全喉切除术的患者（n=244）进行了前瞻性维护的单机构数据库查询。提取人口统计学、临床和生存数据。计算Kaplan Meier生存曲线和风险比（HR）。5年总生存率为49%。5年无病生存率为58%。总生存期的独立预测因素包括重度合并症[ACE-27量表]（HR 3.76; 95% CI 1.56 - 9.06）和阳性复发临床淋巴结（HR 2.91; 95% CI 1.74 - 4.88）。严重合并症状态是总生存率的最强预测因子，这表明增加对减轻健康竞争风险的关注至关重要。这些数据可以为风险预测模型提供信息，以允许集中的共享决策，术前健康优化和辅助治疗的患者选择。
Total laryngectomy remains the treatment of choice for recurrent/persistent laryngeal squamous cell carcinoma(LSCC) after radiation(RT) or chemoradiation(CRT). However, despite attempts at aggressive surgical salvage, survival in this cohort remains suboptimal. A prospectively-maintained single-institution database was queried for patients undergoing total laryngectomy for recurrent/persistent LSCC after initial RT/CRT between 1998–2015(n=244). Demographic, clinical, and survival data were abstracted. Kaplan Meier survival curves and hazard ratios(HR) were calculated. Five-year overall survival was 49%. Five-year disease-free survival was 58%. Independent predictors of overall survival included severe comorbidity[ACE-27 scale](HR 3.76; 95% CI 1.56 – 9.06), and positive recurrent clinical nodes(HR 2.91; 95% CI 1.74 – 4.88). Severe comorbidity status is the strongest predictor of overall survival, suggesting that increased attention to mitigating competing risks to health is critical. These data may inform a risk prediction model to allow for focused shared decision-making, preoperative health optimization and patient selection for adjuvant therapies.
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DOI：
10.1002/hed.24355
发表时间：
2016-04-01
影响因子：
2.9
作者：
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影响因子：
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影响因子：
158.5
作者：
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