锁骨上区原发不明转移癌的治疗与预后分析

Treatment and prognostic analysis of supraclavicular metastasis of unknown primary sites

为探讨影响锁骨上区原发不明转移癌患者的预后因素和治疗方式.对1978年3月～1998年11月住院治疗的锁骨上区原发不明转移癌患者的临床资料进行研究,选择9个可能对其预后产生影响的特征性因素,通过Cox模型进行单因素和多因素分析.结果提示,全组5年生存率27.6%(20/75).影响预后的主要因素是组织学类型、N分级、治疗方式和锁骨上转移灶控制情况(其P值分别为0.000 1、0.000 7、0.005 3和0.001 3).初步研究结果提示,改善锁骨上区原发不明转移癌患者预后的关键是早期诊断,采取手术、化疗、放疗相结合的综合治疗,积极控制锁骨上区转移灶.

The objestive of this study was to study the treatment and prognostic factors of paients with supraclavicular metastasis of unknown prinary sites. Clinical data of patiens with supraclavicular metastasis of unknown primary sites in hospital from March 1978 to November 1998＇ were retrospectively analyzed, and nine characteristic factors which might affect prognosis were selected and analyzed by Cox modal. The overall 5-year survival rate was 27.6%. The main factors affected prognosis were histology type. N-grade. therapy methods, and the control of supraclavicular metastasis （P=0.000 1. 0.000 7, 0.005 3, 0.001 3）. In conclusion, the prognostic improvement ofsupraclavicular metastasis of unknown primany sites mainly deperded on early diagnosis, surgery combinated with chemotherapy and radiotherapy, and the control of supracluvicular metastasis of unknown primary sites.