Charlson-Deyo指数对鼻窦鳞状细胞癌术后总生存率的影响。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-09-17 DOI:10.1002/lio2.70259

David Herz, Aman M. Patel, George S. Bebawy, Anthony M. Saad, Ghayoour S. Mir, Andrey Filimonov

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引用次数: 0

摘要

目的：客观的术前风险评估工具为医生和患者的决策提供信息。本研究探讨了鼻窦鳞状细胞癌（SNSCC）术后Charlson-Deyo共病指数（CCI）与总生存率（OS）之间的关系。方法：在一项回顾性队列研究中，使用2004-2016年国家癌症数据库提取手术的成年pT1-4N0-3 M0 SNSCC患者。采用Kaplan-Meier生存分析和cox比例风险模型分析CCI对OS的影响。结果：在符合纳入标准的3307例患者中，CCI = 0的患者2613例（79.0%），CCI = 1的患者533例（16.1%），CCI = 2+的患者161例（4.9%）。在单因素分析中，CCI组存在年龄差异（CCI = 0组≥65岁者占42.8%，CCI 1组和CCI 2+组分别为53.3%和64.0%,p p p p = 0.069），与CCI = 0相比，CCI组的OS较差无相关性。CCI = 2+ (HR 1.43, 95% CI 1.05 ~ 1.96, p = 0.025)与CCI = 0的OS差相关。结论：在接受手术的成年SNSCC患者队列中，较高的CCI与较差的OS独立相关。这些发现支持使用CCI作为SNSCC患者术后预后的预测指标。未来的研究应该探索共病负担如何与虚弱和其他预后因素相互作用，以完善风险分层工具。证据等级：4。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Charlson–Deyo Index Impact on Overall Survival After Surgery for Sinonasal Squamous Cell Carcinoma

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Charlson–Deyo Index Impact on Overall Survival After Surgery for Sinonasal Squamous Cell Carcinoma

Objectives

Objective preoperative risk assessment tools inform physician and patient decision making. Our study examines the relationship between the Charlson–Deyo comorbidity index (CCI) and overall survival (OS) following surgery for sinonasal squamous cell carcinoma (SNSCC).

Methods

In a retrospective cohort study, the 2004–2016 National Cancer Database was used to extract adult patients with pT1-4N0-3 M0 SNSCC undergoing surgery. Kaplan–Meier survival analysis and Cox-proportional hazards modeling were used to analyze the impact of CCI on OS.

Results

Of the 3307 patients satisfying inclusion criteria, 2613 (79.0%) were CCI = 0, 533 (16.1%) were CCI = 1, and 161 (4.9%) were CCI = 2+. On univariate analysis, CCI groups differed by age (42.8% were ≥ 65 years old in CCI = 0 vs. 53.3% and 64.0% in CCI groups 1 and 2+, respectively, p < 0.001) and race (p < 0.001). There was no significant difference between CCI groups in sex, T-stage, N-stage, margin status, primary site, radiation therapy, or systemic therapy. On Kaplan–Meier analysis, 5-year OS for CCI = 0, CCI = 1, and CCI = 2+ was 58.6%, 48.0%, and 42.9%, respectively (p < 0.001). CCI = 1 (HR 1.20, 95% CI 0.99–1.45, p = 0.069) was not associated with worse OS than CCI = 0. CCI = 2+ (HR 1.43, 95% CI 1.05–1.96, p = 0.025) was associated with worse OS than CCI = 0.

Conclusions

In a cohort of adult patients with SNSCC undergoing surgery, higher CCI was independently associated with worse OS. These findings support the use of CCI as a predictor of postoperative outcomes in SNSCC patients. Future studies should explore how comorbidity burden interacts with frailty and other prognostic factors to refine risk stratification tools.