在cT1-4 N0M0中选择性部剖析 头部和部螺杆细胞癌
Praneet C Kaki1, Aman M Patel2, Hassaam S Choudhry2
1Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
概括
选择性部剖析 (END) 用于头部和部状细胞癌 (HNSpCC) 是常见的,但没有改善生存率. 在END期间检测到的隐藏结节转移 (ONM) 与更糟糕的结果有关,这证明了它的考虑是合理的.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 头部和部癌症研究研究
背景情况:
- 头脊状细胞癌 (HNSpCC) 是一种罕见的恶性瘤.
- 选择性部剖析 (END) 在临床节点阴性 (cN0M0) HNSpCC 管理中的作用仍在争论中.
- 了解与END相关的生存益处和风险对于治疗决策至关重要.
研究的目的:
- 为了比较选择性部剖析 (END) 与手术切除cT1-4 N0M0头棘细胞癌 (HNSpCC) 患者的部观察的生存结果.
- 为了评估隐藏结节转移 (ONM) 对这一患者队列的生存的影响.
主要方法:
- 从2006年到2018年使用国家癌症数据库 (NCDB) 进行回顾性队列研究.
- 包括手术切除cT1-4 N0M0 HNSpCC.的患者.
- 使用线性,二元物流,卡普兰-梅尔和考克斯比例危险回归模型进行分析.
主要成果:
- 在815名患者中,28.8%接受了END,随着时间的推移,利用率越来越高.
- 隐藏的结节转移 (ONM) 在24.7%的END病例中被检测到.
- 在END (54%) 和部观察 (62%) 组 (P=.215),在5年总生存期 (OS) 中没有显著差异.
- 与没有ONM (60%) (P<.001) 的患者相比,经过END的ONM患者的5年生存率 (38%) 显著降低 (P<.001).
- 多变量分析显示,END与OS无关 (aHR为0.74),而ONM与OS较差 (HR为2.01).
结论:
- 选择性部剖析 (END) 经常在cN0M0 HNSpCC中进行,但似乎没有改善整体存活率.
- 隐藏结节转移 (ONM) 的高率及其与生存率较差的关联表明,在HNSpCC管理中需要考虑END.
- 可能需要进一步的研究来完善HNSpCC中END的患者选择.
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