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.
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