老年喉癌患者手术治疗的远期疗效及预后的影响因素

发布时间：2019-05-22 23:04

【摘要】：目的探讨老年喉癌患者手术治疗的远期疗效及其预后影响因素。方法选择喉癌手术患者200例进行研究,所有患者进行随访,选择年龄、性别、吸烟指数、肿瘤原发部位、临床分期、N分期、T分期、病理分级、颈淋巴结清扫术、术式、术后放疗11项临床指标作为分析指标并对其进行量化赋值。结果 200例患者失访12例,随访率为94.0%,其中死于喉癌58例,截尾例数130例,存活127例,死于其他疾病3例。累计生存曲线显示喉癌3年生存率和5年生存率分别为78.5%、71.0%。单因素分析结果显示:年龄、吸烟指数、肿瘤部位、临床分期、N分期、T分期、病理分级与喉癌患者预后有关(P0.05),性别、颈淋巴结清扫术、术式、术后放疗与喉癌患者预后无关(P0.05)。多因素分析结果显示:吸烟量每增加400支/年,喉癌患者死亡风险增加1.476倍;淋巴结分期每增加一期,喉癌患者死亡风险增加1.723倍;T分期每增加一期,喉癌患者死亡风险增加1.547倍;病理分级每增加1级,喉癌患者死亡风险增加2.143倍。结论喉癌3年生存率和5年生存率较高,吸烟、N分期、T分期、病理分级是影响喉癌预后的独立危险因素。
[Abstract]:Objective to investigate the long-term effect and prognostic factors of surgical treatment in elderly patients with laryngeal carcinoma. Methods 200 patients with laryngeal carcinoma were studied. All patients were followed up. Age, sex, smoking index, primary tumor site, clinical stage, N stage, T stage, pathological grade, cervical lymph node dissection and operation were selected. 11 clinical indexes of postoperative radiotherapy were used as analytical indexes and assigned quantitatively. Results 12 of 200 patients lost follow-up, the follow-up rate was 94.0%, including 58 cases of laryngeal carcinoma, 130 cases of truncation, 127 cases of survival and 3 cases of other diseases. The cumulative survival curve showed that the 3-year survival rate and 5-year survival rate of laryngeal carcinoma were 78.5% and 71.0%, respectively. The results of univariate analysis showed that age, smoking index, tumor location, clinical stage, N stage, T stage, pathological grade were related to the prognosis of patients with laryngeal carcinoma (P 0.05), sex, cervical lymph node dissection, operation type, the prognosis of patients with laryngeal carcinoma was related to age, smoking index, tumor location, clinical stage, N stage, T stage and pathological grade. Postoperative radiotherapy was not related to the prognosis of patients with laryngeal carcinoma (P 0.05). The results of multivariate analysis showed that the risk of death in patients with laryngeal cancer increased by 1.476 times for every 400 cigarettes per year, and 1.723 times for patients with laryngeal carcinoma with each increase in lymph node stage, and the risk of death in patients with laryngeal carcinoma was 1.723 times higher than that in patients with laryngeal cancer. With each increase of T stage, the risk of death in patients with laryngeal carcinoma increased 1.547 times, and the risk of death in patients with laryngeal carcinoma increased 2.143 times with the increase of pathological grade 1. Conclusion the 3-year survival rate and 5-year survival rate of laryngeal carcinoma are high. Smoking, N stage, T stage and pathological grade are independent risk factors for prognosis of laryngeal carcinoma.
【作者单位】：绍兴第二医院眼耳鼻喉科;
【分类号】：R739.65

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