Survival predictors after resection of lung metastases of head or neck cancers.
Survival predictors after resection of lung metastases of head or neck cancers.
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DOI：
10.1111/1759-7714.12225
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发表时间：
2015-09
期刊：
影响因子：
2.9
通讯作者：
Ohtsuka T
中科院分区：
文献类型：
--
作者：
Yotsukura M;Kinoshita T;Kohno M;Asakura K;Kamiyama I;Emoto K;Hayashi Y;Ohtsuka T
肺转移瘤切除术可用于治疗多种癌症，但很少有报告检验其对头颈癌的价值。本研究探讨了这些癌症的临床和病理特征与切除肺转移后的生存率之间的关系。 1986 年至 2013 年间，34 名原发性头颈癌肺转移患者在我们机构接受了手术切除。我们回顾性分析其临床和病理特征以及转移切除后患者的生存情况，以寻找不良预后因素。癌症的原发部位是：8名患者的舌头，7名患者的咽部和唾液腺，5名患者的喉部，以及7名患者的其他部位。 19 名患者患有鳞状细胞癌 (SCC)，10 名患者患有腺样囊性癌，5 名患者患有其他诊断。初次手术和转移瘤切除术之间的中位无病间隔 (DFI) 为 40 个月。总体五年生存率为57.9%，中位生存时间为77个月。通过单变量分析，DFI≤26个月、年龄≥60岁和鳞状细胞癌的组织学是预测因子；通过多变量分析，短期 DFI（P = 0.018）和年龄较大（P = 0.046）仍然是不良临床结果的独立预测因素。年轻和长期 DFI 是原发性头颈癌手术治疗后有利于肺转移瘤切除术的因素。
Pulmonary metastasectomies are performed for a variety of cancers, though few reports have examined their merit for head and neck cancers. This study examined the relationship between clinical and pathological characteristics and survival after resection of lung metastases of these cancers. Between 1986 and 2013, 34 patients presenting with pulmonary metastases of primary head or neck cancers underwent surgical resections at our institution. We retrospectively analyzed their clinical and pathological characteristics and the patients’ survival after metastasectomy in search of adverse prognostic factors. The primary sites of cancer were: the tongue in eight patients, the pharynx and salivary glands each in seven, the larynx in five, and miscellaneous sites in seven patients. Squamous cell carcinoma (SCC) was present in 19, adenoid cystic carcinomas in 10, and other diagnoses in five patients. The median disease-free interval (DFI) between the initial surgery and the metastasectomies was 40 months. The overall five-year survival rate was 57.9%, and median survival time was 77 months. By single variable analysis, a DFI of ≤26 months, age ≥60 years, and histology of SCC were predictors; by multiple variable analysis, a short DFI (P = 0.018) and older age (P = 0.046) remained independent predictors of poor clinical outcomes. Young age and a long DFI are factors in favor of pulmonary metastasectomy after surgical treatment of primary head or neck cancers.