口腔癌中远程转移的个体化风险评估:一个经过验证的预测得分模型
Badr Id Said1, Fatimah A Alfaraj2, Gustavo N Marta3
1Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
Journal of the National Cancer Institute
|July 27, 2023
概括
一个新的风险评分系统有效地识别了患有远程转移 (DMs) 高风险的口腔癌患者. 这种工具有助于定制监测和治疗策略,以获得更好的患者结果.
科学领域:
- 在瘤学瘤学.
- 癌症研究 癌症研究
- 临床医学 临床医学
背景情况:
- 口腔癌 (OCC) 由于远程转移 (DMs) 的风险而构成重大挑战.
- 准确预测DM风险对于有效的患者管理和治疗规划至关重要.
研究的目的:
- 开发和验证一种新的风险评分系统,用于预测口腔癌 (OCC) 的远程转移.
- 为了个性化治疗和监测策略,将患者分为不同的风险组.
主要方法:
- 分析了来自四个三级癌症机构的2749名口腔癌患者的队列.
- 患者被随机分配到发现和验证队列中.
- 一个多变量分析确定了包括病态阶段 (pT3-4),结节状态 (pN+),组织学等级 (G3) 和淋巴血管入侵在内的预测因素,以开发风险得分模型.
主要成果:
- 开发的风险评分模型在发现 (C指数=0.79) 和验证 (C指数=0.77) 队列中都显示出出色的区分能力.
- 在发现队列中,高/中等/标准风险组的五年远程转移率为30%/15%/4%,在验证队列中为35%/16%/5%.
- 该模型准确地预测了DMs在各种治疗模式和独立于局部区域失败.
结论:
- 一个经过验证的风险评分系统,包括pT3-4,pN1/2/3,G3和淋巴血管侵入,有效地识别了口腔癌患者的远程转移风险较高.
- 这种预测模型可以为患有OCC的患者提供个性化的风险适应性治疗升级和监测策略.
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