晚期口腔鳞癌患者独立预后因素及生存预测模型的建立

目的 探讨晚期口腔鳞癌患者的独立预后因素并构建生存预测模型。方法 收集117例晚期口腔鳞癌患者的一般资料及既往病史,所有患者均行口腔鳞癌切除术并联合放疗,根据患者情况进行羟基喜树碱及平阳霉素化疗。所有患者随访时间为手术结束至术后5年,记录患者生存情况,分析晚期口腔鳞癌患者预后的独立危险因素。采用SPSS 20.0软件包对数据进行统计学分析。结果 随访期间,2例因其他原因死亡,4例因失访而剔除。剩余111例患者中, 42例死亡,69例存活,生存率为62.16%;年龄、T分期及M分期不同的晚期口腔鳞癌患者生存情况无显著差异（P>0.05）;性别、组织分化程度、N分期及化疗情况不同的晚期口腔鳞癌患者生存情况差异显著（P<0.05）;性别、N分期及是否联合羟基喜树碱与平阳霉素化疗是晚期口腔鳞癌患者生存情况的独立危险因素（P<0.05）;组织分化程度不是晚期口腔鳞癌患者生存情况的独立危险因素（P>0.05）;性别、N分期及是否联合羟基喜树碱与平阳霉素化疗的生存曲线对晚期口腔鳞癌患者生存情况具有一定预测作用。结论 性别、N分期及是否联合羟基喜树碱与平阳霉素化疗是晚期口腔鳞癌患者生存情况的独立危险因素;性别、N分期及是否联合羟基喜树碱与平阳霉素化疗的生存曲线,可作为晚期口腔鳞癌患者的生存预测模型。

Independent prognostic factors and survival prediction model for 117 patients with advanced oral squamous cell carcinoma

PURPOSE: To investigate the independent prognostic factors and establish survival prediction model for advanced oral squamous cell carcinoma (OSCC). METHODS: At the time of admission, the general information and past medical history of 177 patients with advanced OSCC were collected in detail. All patients underwent radical resection. After surgery, radiotherapy and chemotherapy with hydroxycampothecin (HCPT) and pingyangmycin (PYM) were performed according to the patient's condition. All patients were followed up for 5 years after surgery, and the survival rate during that period and the risk factors for prognosis were analyzed. The data were analyzed by SPSS 20.0 software package. RESULTS: During the follow-up period, 2 patients died due to other causes, 4 were excluded due to lost to follow-up, 42 of the remaining 111 patients died, 69 survived, the total survival rate was 62.16%. The survival status of patients with advanced OSCC with different age, T stage and M stage had no significant difference (P>0.05), while significant difference was found among patients with different gender, tissue differentiation degree, N stage and chemotherapy (P<0.05). Gender, N stage and HCPT in combination of PYM chemotherapy were independent risk factors (P<0.05), while histological differentiation degree was not an independent risk factor for survival of patients (P>0.05). The survival curves of gender, N stage and HCPT in combination of PYM chemotherapy had certain predictive value on the survival of patients with advanced OSCC. CONCLUSIONS: Gender, N stage and HCPT in combination of PYM chemotherapy are independent risk factors for the survival of patients with advanced OSCC, and their survival curves can be used as a survival prediction model.