术前全身合并症情况及营养状态对老年口腔鳞癌患者预后的影响

Influence of preoperative comorbidities and nutrition status on elderly patients with oral squamous cell carcinoma

目的 :探讨老年口腔癌患者术前全身合并症情况及营养状态对预后的影响。方法 :收集2010年1月—2012年12月间手术治疗的老年(年龄≥60岁)口腔鳞癌患者的相关病史资料,回顾分析合并症指数(Charlson、HNCA、ACT指数)以及营养指数(nutrition index,NI)对术后生存率的影响。采用SPSS 17.0软件包对数据进行统计学分析。结果:465例患者中,死亡170例,Charlson、HNCA以及ACT指数与患者预后(总生存率OS)无相关性(P=0.747、0.530、0.869),术前营养状态与预后相关,营养指数是老年口腔癌患者预后的独立危险因素(P<0.001),得分越高,预后越差。结论:对于老年口腔鳞癌患者,术前全身系统性疾病并不是影响预后的独立因素,术前营养状态越差,生存率越低。

PURPOSE： To evaluate the influence of pre-operative comorbidities and nutrition status on elderly patients with oral squamous cell carcinoma （OSCC）. METHODS： The data of elderly patients with OSCC treated between January 2010 to December 2012 in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People＇s Hospital, Shanghai Jiao Tong University School of Medicine was analyzed. Patients who were histologically diagnosed as squamous eel1 carcinoma, aged over 60 years and surgically managed were included. The eomorbidity index including Chadson, HNCA and ACT index and nutrition index （NI） were analyzed. RESULTS： Among 465 patients, preoperative Chadson, HNCA and ACT index didn＇t show significant impact on outcome of disease （P=0.747, 0.530, 0.869）. Preoperative nutrition status and nutrition index were independent factors for prediction of prognosis （P 〈0.001）. CONCLUSIONS： For elderly patients with OSCC, preoperative systemic disease is not a predictive factor for prognosis; however, the worse the preoperative nutritional status, the lower the survival rate.