IVc期下咽癌特征分析及列线图预后模型构建

doi:10.6040/j.issn.1673-3770.0.2021.278

摘要/Abstract

摘要： 目的探讨IVc期下咽癌患者临床特征,筛选预后影响因素,构建列线图预后模型。方法在监测、流行病学及预后数据库中收集IVc期下咽癌患者的临床资料,应用χ2检验分析远处转移的相关特征,单因素及多因素Cox回归分析筛选预后影响因素,并构建列线图预后模型。结果肺(53.7%)是最常见的转移部位。位于梨状窝的肿瘤(P=0.029)和高级别肿瘤(P=0.010)更易发生肺转移。手术、化疗、骨和肝转移是独立预后因素。基于独立预后因素的列线图预后模型C-index为0.686(95%CI 0.649-0.723)。结论下咽癌最易向肺转移。基于手术、化疗、有无骨转移和肝转移的列线图预后模型预测能力较好。

关键词: 下咽癌, 列线图, 监测,流行病学及预后数据库, 远处转移

Abstract: Objective Hypopharyngeal carcinoma patients in IVc stage are always associated with poor prognosis and prognostic factors for these patients are largely unknown. We aimed to characterize the prevalence of metastases, and establish a prognostic nomogram for survival prediction. Methods Hypopharyngeal carcinoma patients with IVc stage were collected from surveillance, epidemiology and End Results(SEER)database. Chi-square test was used to analyze the related risk factors of different sites of metastases. Univariate and multivariate Cox regression analyses were performed to analyze the prognostic factors of cancer-specific survival(CSS)in IVc stage patients. The nomogram based on multivariate Cox analysis was then established and validated. Results A total of 283 IVc stage hypopharyngeal carcinoma patients were included in this study. Majority of patients were diagnosed with single metastasis, and lung(53. 7%)was the most common metastasis site. Patients with tumor in pyriform sinus(P=0.029)and high-grade tumors(P=0.010)were more likely to develop lung metastasis. Multivariate Cox analysis showed that bone metastasis(HR=2.239, P<0.001), liver metastasis (HR=1.880, P=0.003), surgical therapy(HR=0.311, P=0.003)and chemotherapy(HR=0.494, P<0.001)were independent prognostic factors for CSS. Independent prognostic factors were integrated into nomogram for CSS prediction, and the C-index was 0.686(95%CI 0.649-0.723). Conclusion Lung metastasis is the most common in IVc stage hypopharyngeal carcinoma patients. For hypopharyngeal carcinoma patients in IVc stage, surgical therapy, chemotherapy, without bone and liver metastases are associated with superior survival outcome. The proposed nomogram has a good predictive ability and may be practical for clinical decision-making.

Key words: Hypopharyngeal carcinoma, Nomogram, Surveillance, Epidemiology, and End Results, Distant metastases

中图分类号:

R739.6

姜超,周炫辰,韩杰,岳志勇. IVc期下咽癌特征分析及列线图预后模型构建[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 49-54.

JIANG Chao, ZHOU Xuanchen, HAN Jie, YUE Zhiyong. Prevalence and prognostic nomogram for IVc stage hypopharyngeal carcinoma patients: a SEER population-based analysis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 49-54.

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