Trend in Initial Management of T4 Laryngeal Squamous Cell Carcinoma.

IF 2.2 3区 医学 Q1 OTORHINOLARYNGOLOGY
Anna J Orr, Michael C Topf, Robert P Zitsch, Patrick T Tassone
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引用次数: 0

Abstract

Background: Contemporary initial management trends for locally advanced laryngeal carcinoma remain unclear. This study evaluated whether initial treatment for clinical tumor stage 4a (cT4a) laryngeal cancer has changed over time and associated survival.

Methods: Retrospective cohort study using the National Cancer Database (NCDB) from 2004 to 2022 of patients with cT4a laryngeal squamous cell carcinoma. Survival outcomes were analyzed with the Mann-Kendall test, Kaplan-Meier method, logistic regression, Cox-proportional hazards, and log-rank tests.

Results: Among 12 142 cT4a laryngeal cancer patients (81.3% male, mean age 60.9 years), initial surgical management increased from 41.0% in 2004 to 65.3% in 2022. Two-year overall survival increased from 58.2% (2004) to 70.3% (2021). Upfront surgery was independently associated with higher 2-year overall survival on multivariable analysis, Kaplan-Meier, and log-rank testing (p < 0.001).

Conclusion: For patients with cT4a laryngeal cancer, management with initial surgery has become more popular and may offer improved overall survival compared to initial nonsurgical management.

T4喉部鳞状细胞癌初期治疗的趋势。
背景:局部晚期喉癌的早期治疗趋势尚不清楚。本研究评估了临床肿瘤期4a (cT4a)喉癌的初始治疗是否随时间和相关生存率发生变化。方法:使用国家癌症数据库(NCDB)对2004 - 2022年cT4a喉部鳞状细胞癌患者进行回顾性队列研究。生存结果分析采用Mann-Kendall检验、Kaplan-Meier法、logistic回归、Cox-proportional hazards和log-rank检验。结果:在12 142例cT4a喉癌患者中(男性81.3%,平均年龄60.9岁),首次手术治疗从2004年的41.0%上升到2022年的65.3%。两年总生存率从58.2%(2004年)增加到70.3%(2021年)。在多变量分析、Kaplan-Meier和log-rank检验中,术前手术与较高的2年总生存率独立相关(p)。结论:对于cT4a喉癌患者,与初始非手术治疗相比,初始手术治疗已变得更受欢迎,并且可能提供更高的总生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.00
自引率
6.90%
发文量
278
审稿时长
1.6 months
期刊介绍: Head & Neck is an international multidisciplinary publication of original contributions concerning the diagnosis and management of diseases of the head and neck. This area involves the overlapping interests and expertise of several surgical and medical specialties, including general surgery, neurosurgery, otolaryngology, plastic surgery, oral surgery, dermatology, ophthalmology, pathology, radiotherapy, medical oncology, and the corresponding basic sciences.
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