喉癌患者手术治疗的远期疗效及影响因素分析.PDFVIP

浙江医学2018 年第40 卷第23 期 荫论 著 喉癌患者手术治疗的远期疗效 及影响因素分析 童巧玲 沈志森 应焱燕 邓红霞 摘要 】 目的 探讨喉癌患者接受手术治疗后的远期疗效及相关影响因素。方法 选择接受手术治疗的喉癌患者 128 例， 对其性别、年龄、吸烟史、饮酒史、肿瘤原发部位、病理分级、肿瘤大小、T 分级、N 分级、临床分期、术式、颈淋巴结清扫及治疗方案共13 项临床资料进行回顾性分析并随访其生存情况。采用Kaplan-Meier 法计算生存率；采用log-rank 检验和Cox 比例风险模型对预后 影响因素进行单因素及多因素分析。结果 128 例患者失访4 例，随访率为96.9% ，存活92 例，死亡32 例；总生存期（OS ）7~60 个 月，1、3、5 年总生存率依次为96.1%、85.9% 、75.0%。单因素分析发现，年龄、肿瘤原发部位、病理分级、肿瘤大小、T 分级、N 分级、临床 分期、术式、颈淋巴结清扫及治疗方式与喉癌患者术后5 年总生存率显著相关（均P＜0.01 ）。多因素分析发现喉癌患者手术预后的独 立危险因素为年龄、病理分级及临床分期（均P＜0.01 ）。结论 手术治疗喉癌的5 年总生存率较高；年龄、病理分级及临床分期是影 响喉癌患者手术预后的独立危险因素。 关键词】 喉癌 手术治疗 生存率 影响因素 Long-term efficacy and influencing factors of surgical treatment for patients with laryngeal cancer China Abstract 】 Objective To explore the long-term efficacy and related influencing factors in patients with laryngeal cancer after surgery. Methods One hundred and twenty eight patients with laryngeal cancer undergoing surgery were included in the study. The gender, age, smoking history, drinking history, primary tumor location, pathological grade, tumor size, T grade, N grade, clinical stage, surgical procedure, cervical lymph node dissection and treatment and the survival of each enrolled patient were documented. The survival rate was calculated using the Kaplan-Meier method. The prognostic factors were analyzed using the Log-rank test and the Cox proportional hazards model. Results The follow-up rate of 128 patients was 96.9%; 92 patients survived and 32 died during the follow up. The overall survival (OS) was 7~60 months. The 1-, 3-, and 5-year overall survival rates were 96.1% , 85.9% , and 75.0% , respectively. The univariate analysis found that age, primary tumor location, pathological grade, tumor size, T grade, N grade, clinical stage, surgical procedure, cervical l