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Contemporary staging and prognosis for primary tracheal malignancies: a population-based analysis. 总被引:7,自引:0,他引:7
Neil Bhattacharyya 《Otolaryngology--head and neck surgery》2004,131(5):639-642
OBJECTIVE: Determine staging characteristics and survival outcomes for primary malignancies of the trachea. Design Cross-sectional analysis of national cancer database. METHODS: Cases of primary tracheal malignancy were extracted from the Surveillance, Epidemiology, and End Results database for the time period 1988-2000. T-stage, N-stage, and overall stage of presentation were determined. Mean, median, and 5-year survival statistics were computed using Kaplan-Meier survival analysis for each tumor histology and for the overall cohort according to stage. RESULTS: Ninety-two cases with adequate histologic information were identified. Mean age at presentation was 59.3 years with an equal sex distribution. Squamous cell carcinoma was the most common tumor type (41 cases) followed by adenoid cystic carcinoma (19 cases). Forty-nine cases (53%) presented with stage 3 or stage 4 disease. Squamous cell carcinoma exhibited poorer survival (mean survival, 44.0 month, 5-year survival, 34%) than adenoid cystic carcinoma (mean survival, 115 month, 5-year survival, 78%). Five-year unadjusted survival rates according to overall stage were 52.8%, 70.0%, 75.0%, 15.1%, respectively. CONCLUSIONS: Primary tracheal malignancies often present with advanced stage. Patients with squamous cell carcinoma of the trachea have poorer prognoses when compared with adenoid cystic carcinoma and other tumor types. Staging tracheal cancer with a TNM-based system helps predict survival. EBM rating: C. 相似文献
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Factors affecting survival in maxillary sinus cancer. 总被引:4,自引:0,他引:4
Neil Bhattacharyya 《Journal of oral and maxillofacial surgery》2003,61(9):1016-1021
PURPOSE: The study goal was to determine survival parameters and clinical factors influencing survival for maxillary sinus malignancies. METHODS: Cases of maxillary sinus malignancy for the time period 1988 to 1998 were extracted from the Surveillance, Epidemiology and End Results database. Cases with distant metastatic disease at presentation were excluded. Clinical information, including tumor histology, grade and stage, and extent of surgery and radiation therapy, were determined. Kaplan-Meier survival and Cox proportional hazards analyses were conducted to determine the influence of these factors on overall survival. RESULTS: The study sample was composed of 650 patients with maxillary sinus cancer (mean age, 64 years; male-to-female ratio, 3:2). The most common histology was squamous cell carcinoma (61.7%), followed by adenoid cystic carcinoma (9.8%). The overall mean (median) survival was 52 months (25 months), and 77.5% and 7.4% of patients presented with advanced (T3/T4) disease or cervical metastasis, respectively. Radiation therapy was administered in 441 patients (67.9%) and significantly improved survival mainly for those with T4 lesions. On multivariate analysis, increasing age, T stage, N stage, and tumor grade independently predicted poorer survival, whereas gender did not. Adenoid cystic carcinoma exhibited a significantly improved overall survival (P <.001). CONCLUSIONS: Survival for patients with maxillary sinus cancer is determined not only by TNM staging but also by tumor histology and grade. TNM staging effectively stratifies patients according to survival. Radiation therapy significantly improves survival for those with T4 lesions. 相似文献
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OBJECTIVE: To determine clinical utility of fine needle aspiration (FNA) in parotid neoplasia. STUDY DESIGN AND SETTING: Retrospective cohort study. METHODS: FNA and final pathology data were reviewed for patients who underwent parotidectomy for malignancy. Surgical outcomes were compared between patients with malignant cytology versus nonmalignant/nondiagnostic cytology. RESULTS: Twenty-seven of 33 primary malignant parotid lesions underwent FNA. Seventeen (63.0%) patients were diagnosed with cancer on FNA. The remaining 16 patients did not undergo FNA (n = 6), had a nondiagnostic FNA specimen (n = 5), or were incorrectly diagnosed with a benign lesion (n = 5). Patients who went on to parotidectomy with intent to treat malignancy based on FNA had significantly higher rates of upfront neck dissections (47.1% vs 12.5%, P = 0.036) as well as clear pathological margins (70.6% vs 31.3%, P = 0.027) vs those with nonmalignant FNA diagnoses. CONCLUSIONS: Preoperative FNA diagnosis of malignancy improves surgical treatment of parotid cancer. SIGNIFICANCE: FNA in the evaluation of parotid masses should strongly be considered. 相似文献
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