喉癌患者手术治疗后复发的危险因素分析

Study on the risk factors for recurrence of laryngeal cancer patients after surgical treatment

目的 探讨喉癌患者手术治疗后复发的危险因素。方法 选取2014年1月至2017年12月在河北邯郸市中心医院行手术治疗的喉癌患者,收集一般资料、既往病史、手术相关指标、实验室检查结果等临床资料,以喉癌是否复发为研究终点,随访截止时间为2022年12月31日,采用单因素和多因素logistic回归分析喉癌术后复发的危险因素。结果 共纳入103例患者,其中21例(20.4%)手术治疗后复发,82例(79.6%)未复发。Logistic回归分析显示,肿瘤分期T4期(OR=37.357,95%CI 5.482~254.571,P<0.001)和N2期(OR=11.335,95%CI 1.065~120.647,P=0.044)是喉癌患者手术治疗后复发的危险因素,而术后放疗为其保护因素(OR=0.125,95%CI 0.024~0.662,P=0.014)。结论 肿瘤分期T4期和N2期是喉癌患者术后复发的危险因素,而术后放射治疗是其保护因素;对于高危患者术后应密切随访,必要时可联合放射治疗以降低复发率。

Objective To investigate the risk factors of recurrence of laryngeal cancer after surgical treatment.Method Laryngeal cancer patients treated in Handan Central Hospital during January 1,2014 to December 31,2017 were selected.General data,past medical history,operation-related indicators,laboratory indicators and other clinical data of patients were collected.The end point of the study was whether laryngeal cancer recurred.The deadline for follow-up was December 31,2022.The risk factors of laryngeal cancer recurrence were determined by univariate and multivariate logistic regression analysis.Result A total of 103 patients with laryngeal cancer were included in this study,of which 21 patients(20.4%)had recurrence and 82 patients(79.6%)had no recurrence.Logistic regression analysis showed that the risk of recurrence in patients with stage N2 laryngeal cancer increased(OR=11.335,95%CI 1.065-120.647,P=0.044),and the risk of recurrence in patients with stage T4 laryngeal cancer increased(OR=37.357,95%CI 5.482-254.571,P<0.001).Postoperative radiotherapy,as a protective factor,reduced the recurrence risk of laryngeal cancer patients(OR=0.125,95%CI 0.024-0.662,P=0.014).Conclusion After surgical treatment of laryngeal cancer,N2 stage and T4 stage are risk factors for recurrence,while postoperative radiotherapy is a protective factor.For high-risk patients,close follow-up should be conducted to reduce the recurrence rate,and combined with radiotherapy to reduce recurrence.