Gender-Related Aspects of Laryngeal Squamous Cell Carcinoma: A Retrospective Cohort Study

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Clinical Otolaryngology Pub Date : 2024-08-07 DOI:10.1111/coa.14206

Nir Tsur, Elchanan Zloczower, Michal Tunik, Ido Amir, Eyal Yosefof, Hagit Shoffel Havakuk, Yaniv Hamzany, Noga Kurman

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Abstract

Objectives

Laryngeal squamous cell carcinoma (SCC) is a predominantly male illness. Although the rate of female patients increased, a knowledge gap exists in the medical literature regarding gender-based differences.

Design

Retrospective cohort study.

Setting

Adult patients treated for laryngeal SCC in a tertiary medical centre between 2006 and 2020. Data were collected on demographics, clinical presentation, treatment modalities, disease recurrence and survival status.

Participants

Two hundred ninety-one patients with laryngeal SCC, 50 (17.2%) females and 241 (82.8%) males.

Main Outcome Measures

Disease-specific survival (DSS), overall survival (OS) and disease-free survival (DFS), as well as differences in disease characteristics and treatment modalities.

Results

Tumour subsites differed significantly between females and males (36% vs. 19.5% supraglottic, 62% vs. 80.5% glottic and 2% vs. 0% subglottic, respectively; p = 0.006). Females were diagnosed at younger ages (61.7 ± 10.58 vs. 65.87 ± 11.11 years, p = 0.016) and advanced-stage disease (58% vs. 39.4%, p = 0.018). Females were treated with combined modalities at higher rates (36% vs. 54.8% for single modality, p = 0.031). DSS rates did not differ between genders (log-rank p = 0.12). Despite being diagnosed at more advanced disease stages, females demonstrated prolonged median OS compared to males (130.17 vs. 106.17 months, log-rank p = 0.017). No significant differences in DFS were observed (log-rank p = 0.32). In a multivariate Cox proportional hazards model, male gender remained an independent negative OS predictor (HR = 2.08; CI, 1.10–3.96; p = 0.025), along with increasing age (HR = 1.06; CI, 1.04–1.09; p < 0.001) and advanced disease stage (HR = 1.7; CI, 1.08–2.67; p = 0.023).

Conclusions

Our findings suggest the importance of considering gender-specific factors in the management of laryngeal SCC.

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喉鳞状细胞癌的性别相关性：一项回顾性队列研究

目的：喉鳞状细胞癌（SCC）主要是一种男性疾病。虽然女性患者的比例有所上升，但医学文献中关于性别差异的知识仍存在空白：设计：回顾性队列研究：背景：2006年至2020年间在一家三级医疗中心接受喉部SCC治疗的成人患者。研究收集了有关人口统计学、临床表现、治疗方式、疾病复发和生存状况的数据：喉SCC患者291人，其中女性50人（17.2%），男性241人（82.8%）：主要结果指标：疾病特异性生存率（DSS）、总生存率（OS）和无病生存率（DFS），以及疾病特征和治疗方式的差异：女性和男性的肿瘤亚部位差异显著（声门上36%对19.5%，声门62%对80.5%，声门下2%对0%；P = 0.006）。女性确诊年龄较小（61.7 ± 10.58 岁 vs 65.87 ± 11.11 岁，p = 0.016），疾病处于晚期（58% vs 39.4%，p = 0.018）。女性接受联合模式治疗的比例更高（36% 对单一模式的 54.8%，p = 0.031）。DSS率在性别上没有差异（对数秩p = 0.12）。尽管女性确诊时处于疾病晚期，但与男性相比，女性的中位OS时间更长（130.17个月 vs. 106.17个月，log-rank p = 0.017）。在 DFS 方面没有观察到明显差异（log-rank p = 0.32）。在多变量考克斯比例危险模型中，男性性别仍然是一个独立的负性 OS 预测因子（HR = 2.08；CI，1.10-3.96；P = 0.025），同时年龄也在增加（HR = 1.06；CI，1.04-1.09；P 结论：我们的研究结果表明，考虑性别因素对癌症治疗的重要性：我们的研究结果表明，在治疗喉SCC时考虑性别特异性因素非常重要。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.