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1、第15卷第6期中国耳鼻咽喉颅底外科杂志Vol.15No.6
2009年12月 ChineseJournalofOtorhinolaryngology-SkullBaseSurgery Dec.2009·临床研究·335例喉癌患者手术治疗预后多因素分析谢 李,田勇泉,赵素萍,刘季威,邱元正,肖健云(中南大学湘雅医院耳鼻咽喉头颈外科,湖南长沙 410008) 摘 要: 目的 通过对335例喉癌术后生存率分析,了解影响预后的相关因素。方法 收集335例初诊喉癌患者的临床和随访资料,采用χ2检验或Fish
2、er确切概率法单因素分析和Cox比例风险回归模型对其预后进行多因素分析。结果 335例喉癌患者,5年疾病特异性生存率为73.2%,5年整体生存率为65.1%。单因素分析显示年龄、解剖分型AJCC2002年分期、手术方式、分化程度、术后并发症、术后放疗、局部复发和术后颈部转移组间生存分布的差异具有统计学意义(P<0.05);多因素分析显示局部复发、术后颈部转移、年龄、术后放疗和声带活动是影响患者生存的独立危险因素。结论 局部复发、术后颈部转移、年龄、术后放疗和声带活动是影响患者生存率的主要因素,早期诊断、坚持术后随访是提高患者生存率的关键。关 键
3、词:喉肿瘤;癌,鳞状细胞;单因素分析;多因素分析;预后中图分类号:R739.65 文献标识码:A 文章编号:1007-1520(2009)06-0426-06Prognosticmultivariateanalysisoflaryngealsquamouscellcarcinomain335patientswithsurgicaltreatmentXIELi,TIANYong2quan,ZHAOSu2ping,etal.(DepartmentofOtolaryngology,XiangyaHospital,CentralSouthUniv
4、ersity,Changsha410008,China) Abstract: Objective Toinvestigatetheprognosticfactorsoflaryngealsquamouscellcarcinomabyanalyzingthepostoperativesurvivalrateof335newly2diagnosedpatientswithsurgicaltreatment.Methods Atotalof335casesofnewly2diagnosedlaryngealsquamouscellcarcinomaw
5、erestudiedretrospectively.Basedontheclincalandfollow2updata,theprognosiswasevaluatedunivariatelyusingChi2squaretest/Fisher’sexacttestandmultivariatelyusingCox’sproportionalhazardregressionmodel.Results The52yeardisease2specificsurvivalandoverallsurvivalrateswere73.2%and65.1%,
6、respectively.Univariateanalysesshowedthatthedifferencesofsurvivalratesbasedonthepatients’age,anatomicalclassification,AJCC02stage,surgicalmanner,histologicaldifferentiation,postoperativecomplications,combinedpostoperativeradiotherapy,localrecurrenceandcervicalmetastasiswerest
7、atisticallysignificant(P<0.05).Multivariateanalysesshowedthatlocalrecurrence,cervicalmetastasis,patients’age,combinedpostoperativeradiotherapyandvocalcordmotionwereindependentprognosticfactors.Conclusion Localrecurrence,cervicalmetastasis,patients’age,combinedpostoperativerad
8、iotherapyandvocalcordmotionaremainfactorsimpactingonthesurvivalofpat
