Cutaneous head and neck squamous cell carcinoma with regional metastases: the prognostic importance of soft tissue metastases and extranodal spread.
Cutaneous head and neck squamous cell carcinoma with regional metastases: the prognostic importance of soft tissue metastases and extranodal spread.
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DOI：
10.1245/s10434-011-1986-7
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发表时间：
2012-01
影响因子：
3.7
通讯作者：
Clark JR
中科院分区：
文献类型：
--
作者：
Kelder W;Ebrahimi A;Forest VI;Gao K;Murali R;Clark JR
结外扩散（ENS）是转移性皮肤鳞状细胞癌（cSCC）的既定不良预后因素;然而，软组织转移（STM）的临床意义尚不清楚。本研究的目的是评估头颈部鳞状细胞癌STM患者的预后，并将其与伴或不伴ENS的淋巴结转移进行比较。纳入了1987年至2007年期间接受初次手术切除治疗的腮腺和/或颈部鳞状细胞癌转移患者。排除标准为转移性淋巴结>3 cm。考克斯比例风险模型用于确定调整其他相关预后因素的STM的效果。该人群包括164例患者，中位随访时间为26个月。远处复发8例，局部复发37例。有22例是癌症特异性死亡，29例患者死亡。短时记忆是降低总体（风险比3.3; 95%置信区间1.6-6.4; P = 0.001）和无病生存期（风险比2.4; 95%置信区间1.4-4.1; P = 0.001）。校正协变量后，STM和受累淋巴结数量是总生存率和无病生存率的重要独立预测因素。在头颈部转移性cSCC中，STM的存在是生存率降低的独立预测因素，并且与单独ENS相比，与更大的不良反应相关。
Extranodal spread (ENS) is an established adverse prognostic factor in metastatic cutaneous squamous cell carcinoma (cSCC); however, the clinical significance of soft tissue metastases (STM) is unknown. The aim of this study was to evaluate the prognosis of patients with STM from head and neck cSCC, and to compare this with that of node metastases with and without ENS. Patients with cSCC metastatic to the parotid and/or neck treated by primary surgical resection between 1987 and 2007 were included. Metastatic nodes >3 cm in size were an exclusion criterion. A Cox proportional hazard model was used to determine the effect of STM adjusting for other relevant prognostic factors. The population included 164 patients with a median follow-up of 26 months. There were 8 distant and 37 regional recurrences. There were 22 were cancer-specific deaths, and 29 patients died. STM was a significant predictor of reduced overall (hazard ratio 3.3; 95% confidence interval 1.6–6.4; P = 0.001) and disease-free survival (hazard ratio 2.4; 95% confidence interval 1.4–4.1; P = 0.001) when compared to patients with node disease with or without ENS. After adjusting for covariates, STM and number of involved nodes were significant independent predictors of overall and disease-free survival. In metastatic cSCC of the head and neck, the presence of STM is an independent predictor of reduced survival and is associated with a greater adverse effect than ENS alone.
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影响因子：
1
作者：
Cabanillas, R.;Secades, P.;Chiara, M. D.
通讯作者：
Chiara, M. D.
DOI：
10.1097/00020840-200304000-00010
发表时间：
2003-04-01
影响因子：
1.6
作者：
Puri, Sajeev K;Fan, Chun-Yang;Hanna, Ehab
通讯作者：
Hanna, Ehab
影响因子：
1.9
作者：
August, M;Wang, J;Wang, CC
通讯作者：
Wang, CC
DOI：
10.1097/00000421-199110000-00004
发表时间：
1991-10-01
影响因子：
2.6
作者：
SHIMM, DS;WILDER, RB
通讯作者：
WILDER, RB
影响因子：
--
作者：
Jose, J;Moor, JW;MacLennan, K
通讯作者：
MacLennan, K