颈部淋巴结阴性下咽癌患者的预后及远期生存分析

Long-term survival and prognosis of hypopharyngeal cancer patients with negative cervical lymph node

目的研究分析淋巴结病理阴性(pN0)下咽鳞状细胞癌患者的生存和预后影响因素。方法回顾性分析2001年1月2014年12月在复旦大学附属眼耳鼻喉科医院行下咽切除术的53例下咽鳞状细胞癌患者资料,所有患者经术前评估均无颈部淋巴结转移,均行颈清扫术并且病理证实无颈部淋巴结转移。收集患者临床病理资料,随访其生存情况并分析预后影响因素。结果梨状窝癌37例,环后区癌7例,咽后壁癌9例。T1级2例,T2级21例,T3级21例,T4级9例。5年无病生存率、疾病特异性生存率、总生存率分别为61.1%、63.6%、42.4%。多因素分析显示食管侵犯是影响复发率、疾病特异性生存率、总生存率的独立危险因素。结论食管侵犯是颈部淋巴结阴性下咽鳞状细胞癌患者的重要预后影响因素,对于食管发生侵犯的患者术后应密切随访。

OBJECTIVE To evaluate the long-term survival and prognosis of patients with pN0 hypopharyngeal squamous cell carcinoma(HPSCC).METHODS A total of53 cases of HPSCC patients who underwent hypopharyngectomy between January 2001 and December 2014 were retrospectively analyzed.Presurgical examination revealed no evidence of lymph node metastases.Unilateral or bilateral cervical lymph node dissection was performed in all patients,and pathologic results revealed no cervical lymph node metastasis.Patient characteristics and survival data were collected and analyzed.RESULTS There were 37 tumors in pyriform sinuses,7 tumors in postcricoid area and 9 in posterior pharyngeal wall.There were 2,21,21,and 9 cases of T1,T2,T3,and T4 lesions,respectively.The 5-year disease-free survival(DSS),cancer-specific survival(CSS)and overall survival(OS)were 61.1%,63.6%,42.4%,respectively.The multivariate analysis showed that esophageal invasion was an independent risk factor for recurrence,disease-specific survival,and overall survival.CONCLUSION Esophageal invasion is an important prognostic factor in patients with pN0 hypopharyngeal cancer,and close follow-up should be conducted for patients with esophageal invasion after treatment.