Ardalan Ebrahimi, Ruta Gupta, Lachlan McDowell, Matthew J R Magarey, Paul N Smith, Klaus-Martin Schulte, Diana M Perriman, Michael Veness, Sandro Porceddu, Tsu-Hui Hubert Low, Allan Fowler, Jonathan R Clark
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引用次数: 0
摘要
背景：我们旨在确定头颈部皮肤鳞状细胞癌（HNcSCC）患者远处转移性复发（DMR）的预测因素，这些患者均接受过治愈性治疗：在对1151名患者进行的一项多中心研究中，采用Cox回归法确定了DMR的预测因素：结果：DMR的5年风险为9.6%。在多变量分析中，免疫抑制（HR 2.93; 95% CI: 1.70-5.05; p 6 cm [相对于≤3 cm (HR 2.77; 95% CI: 1.09-7.03; p = 0.032)]、结节转移≥5个[相对于1-2个 (HR 2.79; 95% CI: 1.63-4.78; p 结论：结节转移的DMR风险为9.6%：结节转移性HNcSCC的DMR风险随免疫抑制、结节大小>6厘米、结节转移≥5个和双侧疾病而增加。在治疗前进行简单的DMR风险评分可能对临床有用。
Predictors of distant metastatic recurrence in head and neck cutaneous squamous cell carcinoma with lymph node metastases treated with curative intent: A multicenter study.
Background: We aimed to identify predictors of distant metastatic recurrence (DMR) in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) with nodal metastases treated with curative intent.
Methods: Predictors of DMR were identified using Cox regression in a multicenter study of 1151 patients.
Results: The 5-year risk of DMR was 9.6%. On multivariate analysis, immunosuppression (HR 2.93; 95% CI: 1.70-5.05; p < 0.001), nodal size >6 cm [versus ≤3 cm (HR 2.77; 95% CI: 1.09-7.03; p = 0.032)], ≥5 nodal metastases [versus 1-2 (HR 2.79; 95% CI: 1.63-4.78; p < 0.001)], and bilateral disease (HR 3.11; 95% CI: 1.40-6.90; p = 0.005) predicted DMR. A DMR risk score was developed that stratified risk from 6.6% (no risk factors) to 100% (≥3 risk factors) (p < 0.001).
Conclusions: The risk of DMR in nodal metastatic HNcSCC increases with immunosuppression, nodal size >6 cm, ≥5 nodal metastases, and bilateral disease. A simple DMR risk score estimated prior to treatment may be clinically useful.
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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