【摘要】 背景与目的:既往研究表明T分期和N分期是喉癌预后的独立影响因素。本研究回顾分析本院治疗的65例喉癌患者,进一步探讨喉癌的生存情况及预后影响因素。方法:收集2000年8月—2007年12月65例喉鳞状细胞癌患者的临床和预后资料,选择9个临床因素,通过单因素分析和Cox模型多因素分析,确定喉癌患者的预后影响因素。结果:经过中位随访期28个月,死于局部复发5例,颈淋巴结转移3例,远处转移2例,非本病死亡2例,原因不明2例。65例患者的3年生存率为74.9%,5年生存率为70.5%。单因素分析结果显示,临床总分期(P=0.021)、N分期(P=0.001)、临床分型(P=0.003)、有无复发(P=0.000)对预后的影响有统计学意义(P<0.05),而年龄、T分期、病理分级、治疗方法与患者的预后无关。Cox多因素分析结果显示,T分期(P=0.006)、淋巴结转移(P=0.025)、复发(P=0.002)和临床分型(P=0.018)是喉癌预后的独立影响因素。结论:喉癌患者预后的独立影响因素是T分期、淋巴结转移、复发、临床分型。坚持治疗后随访、及早发现肿瘤复发、及时行挽救性治疗是提高喉癌患者生存率的关键。更多还原

【Abstract】 Background and purpose:It has been shown in the literature that T and N stage are the independent prognostic factors for laryngeal squamous cell carcinoma(LSCC) . In this study,we retrospectively analyzed 65 cases of LSCC treated in our hospital and investigated the survival rate and its prognostic factors. Methods:From August 2000 to December 2007,65 consecutive patients underwent primary surgical treatment in Cancer Hospital,Fudan University. The clinicopathologic parameters and prognosis were analyzed retrospectively. A total of 9 clinicopathologic factors were studied by univariate analysis and Cox multivariate model. Results:after a median follow-up period of 28 months,5 patients died of local recurrence,3 due to localregional metastasis,2 due to distant metastasis,no-cancer related deaths in 2 cases and 2 cases of unclear reasons. The follow-up rate was 90.73% over 5 years. The overall cumulative survival rate was 74.9% at 3 years,70.5% at 5 years. In univariate analysis,the survival was related to N status,UICC stage,location of the tumor and tumor recurrence,while age,T status,pathologic grade and types of treatment were not correlated to prognosis(P<0.05) . In Cox multivariate modal,T status,N status,location of tumor and recurrence were independent prognostic factors. Conclusion:Independent prognostic factors for patients with LSCC after curative resection are T status,N stage,location of tumor as well as tumor recurrence. Follow-up after therapy and salvage therapy in time should be given to improve the survival of patients with LSCC.更多还原