三个合并症指标对口腔鳞状细胞癌生存终点的预测价值

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-06-18 DOI:10.1016/j.oraloncology.2025.107443

Huan Liu , Liang Peng , Lirui Zhang, Hao Wang, Lei Xiong, Jinghan Wu, Zhien Feng

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引用次数: 0

摘要

合并症对口腔癌预后的负面影响是众所周知的。目前很少有经证实的合并症指标可用于临床管理。本研究旨在确定Charlson共病指数（CCI）、年龄调整共病指数（ACCI）和成人共病评估27 （ACE-27）中与口腔癌生存终点最相关的指标。材料与方法回顾性研究674例口腔鳞状细胞癌（OSCC）患者合并症及其他因素对预后的影响。使用CCI、ACCI和ACE-27对每位患者的合并症进行评估。使用单变量和多变量模型来确定生存的预测因子。结果与ACE-27和CCI相比，严重ACCI是OSCC的唯一有意义的预测因子(无病生存的校正风险比[AHR]: 1.822, 95%可信区间[CI]: 1.237 ~ 2.684, P = 0.002；总生存期AHR [OS]: 2.681, 95% CI: 1.638-4.389, P <；0.001)。更重要的是，ACCI在接受手术和辅助治疗的OSCC患者中显示出良好的预后分层(DFS的ahr：中等，1.692,95% CI: 1.013-2.826, P = 0.044；重度，2.545,95% CI: 1.283-5.049, P = 0.008；OS的ahr：中度，2.004,95% CI: 1.078 ~ 3.725, P = 0.028；重度，3.086,95% CI: 1.397-6.817, P = 0.005)。结论ACCI是判断OSCC预后的重要指标。我们建议将ACCI纳入常规临床评价体系，特别是评估手术联合辅助治疗的OSCC患者的合并症和预后。

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Predictive value of three comorbidity indices for survival endpoints in oral squamous cell carcinoma

Introduction

The negative impact of comorbidities on oral cancer prognosis is well known. Few validated comorbidity indices are currently available for clinical management. This study aimed to determine the most relevant index among the Charlson Comorbidity Index (CCI), Age-Adjusted CCI (ACCI), and Adult Comorbidity Evaluation 27 (ACE-27) in terms of survival endpoints in oral cancer.

Materials and Methods

This retrospective study investigated the impact of comorbidities and other factors on the prognosis of 674 patients with oral squamous cell carcinoma (OSCC). Comorbidities were assessed in each patient using the CCI, ACCI, and ACE-27. Univariate and multivariate models were used to identify the predictors of survival.

Results

Compared to ACE-27 and CCI, severe ACCI was the only meaningful predictor of OSCC (adjusted hazard ratio [AHR] for disease-free survival [DFS]: 1.822, 95 % confidence interval [CI]: 1.237–2.684, P = 0.002; AHR for overall survival [OS]: 2.681, 95 % CI: 1.638–4.389, P < 0.001). More importantly, the ACCI demonstrated excellent prognostic stratification in patients with OSCC undergoing surgery and adjuvant therapy (AHRs for DFS: moderate, 1.692, 95 % CI: 1.013–2.826, P = 0.044; severe, 2.545, 95 % CI: 1.283–5.049, P = 0.008; AHRs for OS: moderate, 2.004, 95 % CI: 1.078–3.725, P = 0.028; severe, 3.086, 95 % CI: 1.397–6.817, P = 0.005).

Conclusion

The ACCI is an essential predictor of OSCC prognosis. We suggest that the ACCI be included in the routine clinical evaluation system, especially to evaluate the comorbidity and prognosis of patients with OSCC undergoing surgery combined with adjuvant therapy.

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.