124例上颌窦癌预后因素分析

目的探讨上颌窦癌的临床病理特征与预后的关系。方法124例上颌窦癌中放疗40例，手术治疗18例，放疗＋手术治疗66例。生存率计算采用Kaplan-Meier法，生存率差异比较采用Logrank检验，多因素分析采用Cox模型。结果5年总生存率、癌症相关生存率和无进展生存率分别为32.5％、37．4％和27．2％。单因素分析显示，肿瘤位置、病理类型、T分期、淋巴结转移情况、临床分期和治疗方式与癌症相关生存（CSS）和无进展生存（PFS）均有相关性；而年龄仅与CSS相关，而与PFS无关。多因素分析显示，病理类型、T分期、临床分期和治疗方式是影响预后的独立因素。结论T分期和临床分期是影响上颌窦癌预后的重要因素。对113～T4期即使淋巴结阴性上颌窦鳞癌，予以颈部预防性照射也是必要的。上颌窦癌的最佳治疗模式仍有待进一步研究。

Prognostic factors of maxillary sinus epithelial carcinoma

Objective To evaluate the relation between clinicopathological character-istics and prognosis in maxillary sinus epithelial carcinoma(ECMS).Methods 124 such patients were reviewed retrospectively.There were treated by radiotherapy alone(RT-,40 patients),surgery alone(S-,18 patients)and combined modality therapy(R+S-,66 patients).Kaplan-Meier method was used to analyze the survival,Logrank test was used to compared the difference between groups.Multivariate analysis was performed by Cox proportional hazard model.Results The overall 5-year survival,cancer-specific survival and progression-free survival rates were 32.5%,37.4% and 27.2%,respectively.Univariate analysis showed that tumor location,histological type,T stage,N stage,clinical stage and treatment modality were associated with cancer-specific survival and progression-free survival,while age was only associated with cancer-specific survival.Multivariate analysis indicated that histological type,T stage,clinical stage and treatment modality were independent prognostic factors.Conclusions T stage and clinical stage are the independent prognostic factors for maxillary sinus epithelial carcinoma.Prophylactic neck irradiation is necessary even for T3-T4N0 patients.The best treatment strategy for maxillary sinus carcinoma needs further research.