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Treatment Package Time in Node-Positive Cutaneous Head and Neck Squamous Cell Carcinoma.

淋巴结阳性皮肤头颈部鳞状细胞癌的治疗包时间。

  • 影响因子:2.28
  • DOI:10.1016/j.prro.2019.09.009
  • 作者列表:"Daniels CP","Bressel M","Corry J","Cole A","Chua MS","Tiong A","Hirshoren N","Dixon B","McDowell L
  • 发表时间:2020-01-01
Abstract

PURPOSE:Treatment package time (TPT) prolongation is associated with lower overall survival and locoregional control in mucosal head and neck squamous cell carcinoma (SCC), but there are few reports in cutaneous HNSCC (cHNSCC). We sought to test the effect of TPT in a cohort of patients with cHNSCC. METHODS:This is a single institution retrospective study of node-positive cHNSCC patients involving either the parotid or cervical nodes treated with curative intent surgery with macroscopic tumor clearance followed by standard fractionation postoperative radiation therapy (PORT) from 2001 to 2014. We assessed the effect of TPT and other prognostic variables on overall survival (OS), cHNSCC specific survival (CSS) progression free survival (PFS), and freedom from locoregional failure (FFLRF). RESULTS:In the present study, 152 patients met the inclusion criteria. The 5-year OS, CSS, PFS, and FFLRF were 62% (95% confidence interval [CI], 54-71), 78% (95% CI, 71-87), 54% (95% CI, 46-64), and 76% (95% CI ,68-85), respectively. In a multivariable model, TPT ≥14 weeks was associated with worse outcomes in all endpoints (OS [hazard ratio (HR) 4.93; 95% CI, 2.54-9.56, P < .001], CSS [HR 6.09; 95% CI, 2.33-15.92; P = .001], PFS [HR 4.29; 95% CI, 2.21-8.34; P < .001], and FFLRF [HR 4.63; 95% CI, 1.71-12.51; P = .007]). Immunosuppression and the presence of ≥2 pathologically involved lymph nodes were also significant adverse factors for both OS and FFLRF, although extracapsular extension was also associated with lower FFRLF. Delays to commencing PORT rather than treatment breaks accounted for the majority of cases with prolonged TPT. CONCLUSIONS:Prolongation of TPT to 14 weeks or longer may confer a lower probability of locoregional control and survival in patients with lymph node-positive cHNSCC treated with surgery and PORT. Timely referral and commencement of PORT is necessary to maximize long-term disease outcomes.

摘要

目的: 在粘膜头颈部鳞状细胞癌 (SCC) 中,治疗包时间 (TPT) 延长与较低的总生存期和局部控制相关,但皮肤HNSCC (cHNSCC) 的报道较少。右室心尖部起搏test对TPT队列患者cHNSCC. 方法: 这是一项针对淋巴结阳性cHNSCC患者的单一机构回顾性研究,涉及腮腺或颈部淋巴结,采用根治性意向手术治疗,肿瘤肉眼清除,随后进行标准分割术后放射治疗 (PORT) 从 2001 年到 2014 年。我们评估了TPT和其他预后变量对总生存期 (OS) 、cHNSCC特异性生存期 (CSS) 、无进展生存期 (PFS) 和无局部区域失败 (FFLRF) 的影响。 结果: 在本研究中,152 例患者符合纳入标准。5 年OS、CSS、PFS和FFLRF分别为 62% (9 5% 置信区间 [CI],5 4-71) 、 78% (9 5% CI,71-87) 、 5 4% (9 5% CI,46-64) 和 76% (9 5% CI,68-8 5)。在多变量模型中,TPT ≥ 14 周与所有终点不良结局相关 (OS [风险比 (HR) 4.93; 95% CI,2.54-9.56,P <。001],CSS [HR 6.09; 95% CI,2.33-15.92; P = .001],PFS [HR 4.29; 95% CI,2.21-8.34;P <.001] 和FFLRF [HR 4.63; 95% CI,1.71-12.51; P = .007])。免疫抑制和存在 ≥ 2 个病理受累淋巴结也是OS和FFLRF的显著不良因素,尽管囊外延伸也与较低的FFRLF相关。开始口岸而不是治疗中断的延迟占大多数长期TPT病例。 结论: 在接受手术和端口治疗的淋巴结阳性cHNSCC患者中,将TPT延长至 14 周或更长时间可能会降低局部区域控制和生存的概率。及时转诊和开始港口是最大限度地提高长期疾病结局的必要条件。

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影响因子:2.93
发表时间:2020-01-01
DOI:10.1016/j.jaad.2019.04.067
作者列表:["Pham CT","Juhasz M","Sung CT","Mesinkovska NA"]

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影响因子:0.96
发表时间:2020-01-01
DOI:10.1097/DAD.0000000000001459
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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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