头颈伴食管三原发癌的临床特征及预后分析  

Clinical features and prognosis of head and neck cancer in patients with esophagus cancer and triple primary carcinoma

作　　者：郑伟慧 楼建林[2] 赵坚强[2] 郭良[2] 毛伟敏 Zheng Weihui;Lou Jianlin;Zhao Jianqiang;Guo Liang;Mao Weimin(Education and Training Office, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China;Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China)

机构地区：[1]苏州大学附属第一医院研究生处,215006 [2]浙江省肿瘤医院头颈外科,杭州310022

出　　处：《中国基层医药》2019年第5期568-572,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技面上项目(2018KY310);浙江省医药卫生重大科技计划省部共建重点项目(WKJ-ZJ-1712);浙江省医药卫生科技计划项目(2015KYA036);浙江省医药卫生科技计划项目(2017KY029).

摘　　要：目的总结头颈伴食管三原发癌(TPC)的临床及预后特点。方法回顾性分析浙江省肿瘤医院2007年1月至2016年12月收治的头颈伴食管TPC患者30例的癌种分布情况、同时性(同时和发生在6个月之内)与异时性癌(>6个月)发病情况,并比较两者的临床特征和预后情况,同时比较不同住院次数和治疗方式对生存情况的影响。结果30例头颈伴食管TPC患者中,下咽+食管+肺和下咽+食管+口咽的发生率为20.0%(6/30),其次是下咽+食管+喉。同时性和异时性各占15例,异时性的手术率(73.3%,11/15)和住院次数[住院次数≥5次为73.3%(11/15)]高于同时性的手术率(33.3%,5/15)和住院次数[住院次数≥5次为33.3%(5/15)],两者差异均有统计学意义(χ^2=4.661、4.661,均P<0.05)。同时性癌的1、3、5年生存率分别为39.9%、19.9%、0.0%,中位生存时间(10.0±2.9)个月;异时性癌1、3、5年生存率分别为78.7%、77.8%、59.1%,中位生存时间(37.0±33.9)个月。两者差异均有统计学意义(生存率:χ^2=10.934,P=0.001;中位生存时间:t=3.201,P=0.003)。住院次数≥5次与<5次生存率差异有统计学意义(χ^2=10.574,P=0.001)。单独的手术、化疗和靶向治疗两者生存期(OS)差异无统计学意义(P>0.05)。结论头颈伴食管TPC,通过多学科综合的多次治疗,仍可具有较高的生存率,尤其是异时性癌。Objective To investigate the clinical features and prognostic characteristics of head and neck cancer in patients with esophagus cancer and triple primary carcinoma(TPC). Methods A total of 30 patients with head and neck cancer with esophagus cancer TPC were collected in Zhejiang Cancer Hospital from January 2007 to December 2016.The distribution of cancer kinds and the incidence of synchronous and metachronous cancer were described.The clinical characteristics and prognosis were also compared in synchronous and metachronous cancer.The influence of number of hospitalization and different treatments on the survival time were analyzed. Results The TPC of "laryngeal pharynx + esophagus + lung" and "laryngeal pharynx + esophagus + oropharynx" had the highest incidence, that was 20.0% in 30 patients(6/30). The second type was "laryngeal pharynx+ esophagus+ larynx". Fifteen cases were synchronous cancer and other 15 cases were metachronous cancer.The rate of surgery was 73.3%(11/15), and the number of hospitalization who more or equal than 5 was 73.3%(11/15) in the synchronous cancer.While the rate of surgery was 33.3%(5/15), and the number of hospitalization who more or equal than 5 was 33.3%(5/15) in the metachronous cancer.There were significant differences between synchronous and metachronous cancer(χ^2=4.661, 4.661, all P<0.05). The 1-year, 3-year and 5-year survival rates were 39.9%, 19.9% and 0.0% in patients with synchronous cancer.The mean survival time was (18.4±6.2)months.In contrast, the survival rates were 78.7%, 77.8% and 59.1% in metachronous cancer.The mean survival time was (122.2±17.2)months.There were significant differences between the two groups (survival rate:χ^2=10.934, P=0.001;mean survival time: t=3.201, P=0.003). The survival rate of the number of hospitalization more than or equal to 5 times had significant difference compared with those less than 5 times(χ^2=10.574, P=0.001). There was no statistically significant difference in the improvement of OS between single operation, chemotherap

关 键 词：头颈部肿瘤 食管肿瘤 癌 原位 肿瘤 多原发性 肿瘤 继发原发性 肿瘤治疗方案 综合疗法 预后 

分 类 号：R739.91[医药卫生—肿瘤] R735.1[医药卫生—临床医学]