A retrospective study on the prognosis of endoscopic surgery for 385 early glottic cancer patients
10.3760/cma.j.cn115330-20240605-00338
- VernacularTitle:早期声门型喉癌385例内镜手术疗效的回顾性研究
- Author:
Jun JU
1
;
Jiasen WANG
;
Siyuan HOU
;
Shizhen ZOU
;
Jing ZHAO
;
Lili PENG
;
Jinrang LI
Author Information
1. 中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部咽喉嗓音外科 国家耳鼻咽喉疾病临床医学研究中心，北京 100853
- Keywords:
Early glottic carcinoma;
Cox proportional hazards regression model;
Random Survival Forest model;
Disease-free survival;
Overall survival
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2024;59(10):1020-1028
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognosis and influencing factors of endoscopic surgery for early glottic carcinoma.Methods:In this retrospective study, we applied the Cox proportional hazards regression model and the random survival forest model to analyze the clinical characteristics of 385 patients [362 males, 23 females, age ranging from 33 to 91 years (62.0±9.6)] who visited the Sixth Medical Center of the General Hospital of the People's Liberation Army from January 2009, to December 2022 and diagnosed with early glottic carcinoma, encompassing variables such as age, gender, T stage, surgical approach, pathological typing, etc. The primary evaluation indicators were overall survival(OS) and disease-free survival rates (DFS). The follow-up duration ranged from 30 to 5,557 days (with a median follow-up time of 1,596 days).Results:After a three-year follow-up, the OS rate for the 385 patients was 95.83%, while the DSF rate was 82.98%. The Cox proportional hazards regression analysis revealed age ( HR=2.35, 95% CI: 1.75 to 3.15, P<0.001) and T staging ( HR=1.59, 95% CI: 1.13 to 2.23, P=0.019) as predominant factors affecting the OS and DFS. The random survival forest model identified poor tumor differentiation, and high expression of P53 and Ki-67 as predictors of inferior prognosis. Conclusion:Endoscopic surgery for early glottic carcinoma yields favorable short-term OS and reduces short-term recurrence rates, with T-stage emerging as a pivotal factor influencing recurrence. Tumors with poor differentiation and elevated expression of P53 may be indicative of an increased risk of recurrence.
