未行喉切除术及放化疗治疗的喉癌患者生存分析

目的 探讨未接受喉切除术及放化疗治疗喉癌患者的生存率及其预后因素.方法 回顾性分析167例未行喉切除术及放化疗治疗喉癌患者的临床资料,应用Kaplan-Meier法计算生存率,单因素分析组间比较采用Log-rank检验,多因素分析采用Cox比例风险模型.结果 167例患者总的生存时间为(16.0±1. 4)个月(-x±s),1年、2年生存率分别为56.4%、26.5%;确诊超过5年的病例(除失访者外)尚无一例生存超过5年.单因素分析显示不同的肿瘤生长部位、病理分级、T分期、N分期对生存率的影响差异有统计学意义(P值均＜0.05).而行气管切开术的喉癌患者生存率与未行气管切开术者相比,差异无统计学意义(P＞0.05).多因素分析显示不同T分期、N分期对生存率的影响差异有统计学意义(危险比分别为1.812和1.557,P值均＜0.05).结论 喉癌病程发展较快,在未针对肿瘤本身治疗的情况下,姑息性手术如气管切开术并不能提高生存率.影响喉癌预后的因素为肿瘤生长部位、病理分级、T分期、N分期和临床分期,其中相对独立预后危险因素为T分期和N分期.

Abstract：

Objective To investigate the survival rate and prognostic factors of laryngeal carcinoma patients with no surgery,radiotherapy or chemotherapy.Methods One hundred and sixty-seven laryngeal carcinoma cases with no surgery,radiotherapy or chemotherapy were analyzed restrospectively.Survival rates were calculated by Kaplan-Meier product-limit method.With univariate analysis,comparisons among/between groups were performed using Log-rank test.Multivariate analysis was carried out using Cox proportional hazard model.Results Overall survival time was (16.0 ± 1.4) months (-x ± s),overall 1-and 2-year survival rates were 56.4％ and 26.5％,respectively.No patient survived over 5 years in these cases who had been diagnosed more than 5 years (except for those who lost).Univariate analysis showed that primary site,pathological grade,T-stage,N-stage and clinical stage were significant prognostic factors for the survival of the patients (P ＜ 0.05＝.The survival rates of laryngeal carcinoma whether with tracheotomy were no statistically significant (P＞0.05).Multivariate analysis showed survival rates statistically correlated with T stage and N stage (hazard ratio were 1.812 and 1.557,P ＜ 0.05).Conclusions The development of laryngeal carcinoma course was faster,without treatment to the tumor itself,even if palliative surgical such as tracheostomy would not improve the survival rate.In laryngeal carcinoma patients with no surgery,radiotherapy or chemotherapy,the factors affecting the survival rates include primary site,pathological grade,T-stage,N-stage and clinical stage,and of them,T-stage and Nstage are the independent prognostic factors.

Survival analysis for laryngeal carcinoma patients with no surgery, radiotherapy or chemotherapy

Objective To investigate the survival rate and prognostic factors of laryngeal carcinoma patients with no surgery,radiotherapy or chemotherapy.Methods One hundred and sixty-seven laryngeal carcinoma cases with no surgery,radiotherapy or chemotherapy were analyzed restrospectively.Survival rates were calculated by Kaplan-Meier product-limit method.With univariate analysis,comparisons among/between groups were performed using Log-rank test.Multivariate analysis was carried out using Cox proportional hazard model.Results Overall survival time was (16.0 ± 1.4) months (-x ± s),overall 1-and 2-year survival rates were 56.4％ and 26.5％,respectively.No patient survived over 5 years in these cases who had been diagnosed more than 5 years (except for those who lost).Univariate analysis showed that primary site,pathological grade,T-stage,N-stage and clinical stage were significant prognostic factors for the survival of the patients (P ＜ 0.05＝.The survival rates of laryngeal carcinoma whether with tracheotomy were no statistically significant (P＞0.05).Multivariate analysis showed survival rates statistically correlated with T stage and N stage (hazard ratio were 1.812 and 1.557,P ＜ 0.05).Conclusions The development of laryngeal carcinoma course was faster,without treatment to the tumor itself,even if palliative surgical such as tracheostomy would not improve the survival rate.In laryngeal carcinoma patients with no surgery,radiotherapy or chemotherapy,the factors affecting the survival rates include primary site,pathological grade,T-stage,N-stage and clinical stage,and of them,T-stage and Nstage are the independent prognostic factors.