97例45岁以下舌及口咽鳞癌患者生存率及其影响因素的分析

目的 探讨影响低龄舌及口咽鳞癌患者生存率的影响因素.方法 调查97例年龄低于45岁舌及口咽鳞癌患者治疗记录及随访记录.采用Cox风险比例风险模型对11个可能影响患者生存率的因素进行筛选.Kaplan-Meier法对各主要因素进行生存率分析并计算生存率.Log-rank法比较各因素不同水平生存分布的差异.结果 TNM分期和原发肿瘤是否切除彻底是影响患者生存率的最主要因素,其P值与RR值分别为:P=0.001,RR=1.870和P=0.017,RR=2.759.各因素不同水平间差异有显著性.资料未显示原发灶切除方式和是否保留下颌骨对生存率有明显影响.结论 早期治疗,彻底切除原发灶以及适当采用选择性颈淋巴清扫术是延长患者生存率的有效方法.

Multivariate analysis of survival rate and prognostic factors in 97 patients with tongue or oropharyngeal squamous cell carcinoma under 45 years

Objective To analyze the prognostic factors which influence the survival rates in younger patients with tongue or oropharyngeal squamons cell carcinoma. Methods A total of 97 consecutive patients with tongue or oropharyngeal carcinoma under 45 years were included in the study. The treatment and follow-up records were reviewed retrospectively. Cox proportional hazards model was used to identify the statistically significant prognostic factors in the 10 potential effective factors. Kaplan-Meier method was used to estimate the overall survival rate and analyze the survival rate under the different levels of the different factors, and log-rank method used for comparison of the distribution of the different survival rates. Results The most important factors that influnced the survival rate were TNM stage and the surgical margin. The P value and the relative risk were P =0. 001, RR = 1. 870 and P =0. 017, RR =2. 759, respectively. There was statistically significant difference among the different levels of the different factors. Coilchlsion The treatment in early TNM stages, cleanness of the surgical margins and proper use of elective neck dissection for cN0 patients were critical factors to prolong patients survival .