Prognostic markers in metastatic cutaneous squamous cell carcinoma of the head and neck
Prognostic markers in metastatic cutaneous squamous cell carcinoma of the head and neck
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DOI：
10.1002/hed.24683
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发表时间：
2017-04-01
影响因子：
2.9
通讯作者：
Gyorki, David
中科院分区：
文献类型：
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作者：
Hirshoren, Nir;Danne, Julia;Gyorki, David
背景。少数头颈部皮肤鳞状细胞癌（SCC）转移到区域淋巴结。本研究的目的是描述淋巴结阳性头颈部皮肤鳞状细胞癌患者行淋巴结切除术的临床结果和预后因素。我们采用Kaplan-Meier方法进行回顾性单中心研究，调查总生存率（OS）和局部区域控制率。评估Cox比例风险模型以确定预后因素。149例淋巴结切除术中阳性淋巴结中位数为颈部2例，腮腺1例。5年OS和局部控制率分别为50%和77%。高龄患者（风险比[HR]， 1.04; p = 0.015）、免疫抑制患者（风险比[HR]， 2.06; p = 0.034）、总淋巴结比高患者（阳性淋巴结数除以总淋巴结数计算；多因素分析[MVA]；风险比[HR]， 1.13; p = 0.019）的OS较差。低总淋巴结比例与淋巴结阳性头颈部皮肤鳞状细胞癌预后改善相关。(C) 2017 Wiley期刊公司
Background. The minority of head and neck cutaneous squamous cell carcinomas (SCC) metastasize to regional lymph nodes. The purpose of this study was to describe the clinical outcomes and prognostic factors for patients with node-positive head and neck cutaneous SCC who underwent lymphadenectomy.Methods. We conducted a retrospective single center study using the Kaplan-Meier method for the investigation of the overall survival (OS) and locoregional control rates. The Cox proportional hazards model was evaluated to identify prognostic factors.Results. The median number of positive lymph nodes from 149 lymphadenectomies was 2 in the neck and 1 in the parotid gland. The 5-year OS and locoregional control rates were 50% and 77%, respectively. OS was worse among older patients (hazard ratio [HR], 1.04; p = .015), immunosuppressed patients (HR, 2.06; p = .034), and patients with a high total lymph node ratio (calculated from the number of positive lymph nodes divided by the total number of nodes; multivariate analysis [MVA]; HR, 1.13; p = .019).Conclusion. Low total lymph node ratio is associated with improved outcomes in node-positive head and neck cutaneous SCC. (C) 2017 Wiley Periodicals, Inc.