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Patterns of Care and Survival of Cutaneous Angiosarcoma of the Head and Neck.

头颈部皮肤血管肉瘤的护理和生存模式。

  • 影响因子:2.23
  • DOI:10.1177/0194599820905495
  • 作者列表:"Chang C","Wu SP","Hu K","Li Z","Schreiber D","Oliver J","Givi B
  • 发表时间:2020-06-01
Abstract

OBJECTIVE:To analyze the patterns of care and survival of cutaneous angiosarcomas of the head and neck. STUDY DESIGN:Retrospective cohort study. SETTING:National Cancer Database. METHODS:The National Cancer Database was queried to select patients with cutaneous angiosarcoma of the head and neck between 2004 and 2015. For survival analysis, patients were included only if they received definitive treatment and complete data. Prognostic factors were analyzed by univariate and multivariable Cox regression. RESULTS:We identified 693 patients diagnosed with head and neck angiosarcomas during the study period. The majority were male (n = 489, 70.6%) and elderly (median, 77 years). A total of 421 patients (60.8%) met the criteria for survival analyses. These patients were treated with surgery and radiation (n = 178, 42.3%), surgery alone (n = 138, 32.8%), triple-modality therapy (n = 48, 11.4%), surgery and chemotherapy (n = 29, 6.9%), and chemoradiation (n = 28, 6.7%). With a median follow-up of 29 months, the 3-year survival was 50.1%. Patients undergoing surgery had better median survival than those who did not (38.1 vs 21.0 months, P = .04). Age, comorbidity, tumor size, and surgical margins were significant factors in univariate analyses. On multivariable analysis, age ≥75 years (hazard ratio, 2.65; 95% CI, 1.80-3.88; P < .001) and positive margins (hazard ratio, 1.91; 95% CI, 1.44-2.51; P < .001) predicted worse overall survival. CONCLUSION:Angiosarcoma of head and neck is a rare malignancy that affects the elderly. Surgical treatment with negative margins is associated with improved survival. Even with curative-intent multimodality treatment, the survival of patients aged ≥75 years is limited.

摘要

目的: 分析头颈部皮肤血管肉瘤的护理和生存模式。 研究设计: 回顾性队列研究。 单位: 国家癌症数据库。 方法: 查询国家癌症数据库,选择 2004 年至 2015 年间头颈部皮肤血管肉瘤患者。对于生存分析,仅在患者接受明确治疗和完整数据的情况下才纳入患者。通过单变量和多变量Cox回归分析预后因素。 结果: 我们在研究期间确定了 693 例诊断为头颈部血管肉瘤的患者。大多数是男性 (n = 489,70.6%) 和老年人 (中位数,77 岁)。共有 421 例患者 (60.8%) 符合生存分析标准。这些患者分别接受手术和放疗 (n = 178,42.3%) 、单纯手术 (n = 138,32.8%) 、三联疗法 (n = 48,11.4%) 、手术和化疗 (n = 29,6.9%) 和放化疗 (n = 28,6.7%)。中位随访 29 个月,3 年生存率为 50.1%。接受手术的患者中位生存期优于未接受手术的患者 (38.1 个月vs 21.0 个月,P = .04)。在单因素分析中,年龄、共病、肿瘤大小和手术切缘是重要因素。在多变量分析中,年龄 ≥ 75 岁 (风险比,2.65; 95% CI,1.80-3.88; P < .001) 和阳性边缘 (风险比,1.91; 95% CI,1.44-2.51; P < .001) 预示总生存期更差。 结论: 头颈部血管肉瘤是一种罕见的恶性肿瘤,累及老年人。切缘阴性的手术治疗与生存率改善相关。即使采用治愈性意向综合治疗,年龄 ≥ 75 岁的患者的生存期也有限。

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影响因子:2.93
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影响因子:0.96
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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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