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

doi:10.19438/j.cjoms.2017.03.009

中国口腔颌面外科杂志 ›› 2017, Vol. 15 ›› Issue (3): 235-239.doi: 10.19438/j.cjoms.2017.03.009

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

刘喆麒，曹巍，任振虎，彭灿邦，季彤*，王悦平*

上海交通大学医学院附属第九人民医院·口腔医学院口腔颌面-头颈肿瘤科，上海市口腔医学重点实验室，上海 200011

收稿日期:2016-08-22 修回日期:2016-11-28 出版日期:2017-05-20 发布日期:2017-06-09
通讯作者: 国家自然科学基金（81672745，81671009）；上海高校高峰高原学科建设项目
作者简介:刘喆麒（1992-），男，硕士，住院医师，E-mail：734672500@qq.com
基金资助:
王悦平，E-mail：18121213995@163.com；季彤，E-mail：jitong70@hotmail.com。*共同通信作者

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

LIU Zhe-qi, CAO Wei, REN Zhen-hu, PENG Can-bang, JI Tong, WANG Yue-ping.

Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine；Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2016-08-22 Revised:2016-11-28 Online:2017-05-20 Published:2017-06-09

摘要/Abstract

摘要： 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。

关键词: 老年人, 口腔鳞癌, 营养状态, 预后

Abstract: 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 cell carcinoma, aged over 60 years and surgically managed were included. The comorbidity index including Charlson, HNCA and ACT index and nutrition index (NI) were analyzed. RESULTS: Among 465 patients, preoperative Charlson, 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.

Key words: Elderly patients, Oral squamous cell carcinoma, Nutrition status, Prognosis

中图分类号:

R739.8

刘喆麒，曹巍，任振虎，彭灿邦，季彤*，王悦平*. 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[J]. 中国口腔颌面外科杂志, 2017, 15(3): 235-239.

LIU Zhe-qi, CAO Wei, REN Zhen-hu, PENG Can-bang, JI Tong, WANG Yue-ping.. Influence of preoperative comorbidities and nutrition status on elderly patients with oral squamous cell carcinoma[J]. China J Oral Maxillofac Surg, 2017, 15(3): 235-239.

参考文献

[1] Piccirillo JF, Tierney RM, Costas I, et al. Prognostic importance of comorbidity in a hospital-based cancer registry [J]. JAMA, 2004, 291(20): 2441-2447.
[2] Lacy PD, Piccirillo JF, Merritt MG, et al. Head and neck squamous cell carcinoma: better to be young [J]. Otolaryngol Head Neck Surg, 2000, 122(2): 253-258.
[3] Pugliano FA, Piccirillo JF, Zequeira MR, et al. Clinical-severity staging system for oral cavity cancer five-year survival rates [J]. Otolaryngol Head Neck Surg, 1999, 120(1): 38-45.
[4] Van Acht MJ, Hermans J, Boles DE, et al. The prognostic value of hemoglobin and a decrease in hemoglobin during radiotherapy in laryngeal carcinoma [J]. Radiother Oncol, 1992, 23(4): 229-235.
[5] Dubray B, Mosseri V, Brunin F, et al. Anemia is associated with lower local-regional control and survival after radiation therapy for head and neck cancer: a prospective study[J]. Radiology, 1996, 201(2): 553-558.
[6] Thrnawski R, Skladowski K, Maciejewski B. Prognostic value of haemoglobin concentration in radiotherapy for cancer of supraglottic larynx [J]. Int J Radiat Oncol Biol Phys, 1997, 38(5): 1007-1011.
[7] Lee WR, Berkey B, Marcial V, et al. Anemia is associated with decreased survival and increased locoregional failure in patients with locally advanced head and neck carcinoma: a secondary analysis of RTOG 85-27 [J]. Int J Radiat Oncol Biol Phys, 1998, 42(5) : 1069-1075.
[8] Warde P, O'Sullivan B, Bristow RG, et al. Tl/T2 glottic cancer managed by external beam radiotherapy: the influence of pretreatmenthaemoglobin on local control [J]. Int J Radiat Oncol Biol Phys, 1998, 41(2): 347-353.
[9] Lutterbach J, Guttenberger R. Anemia is associated with decreased local control of surgically treated squamous cell carcinoma of the glottis larynx [J]. Int J Radiat Oncol Biol Phys, 2000, 48(5): 1345-1350.
[10] Daly T, Poulsen MG, Denham Jw, et al. The effect of anaemia on efficacy and normal tissue toxicity following radiotherapy for
locally advancedsquamous cell carcinoma of the head and neck [J]. Radiother Oncol, 2003, 68(2): 113-122.
[11] Reichel O, Panzer M, Wimmer C, et al. Prognostic implications ofhemoglobin levels before and after surgery as well as before and after radiochemotherapy for head and neck tumors [J]. Eur Arch Otorhinolaryngol, 2003, 260(5): 248-253.
[12] Schafer U, Micke O, Muller SB, et al. Hemoglobin as an independentprognostic factor in the radiotherapy of head and neck tumors [J]. Strahlenther Onkol, 2003, 179(8): 527-534.
[13] Cho EI, Sasaki CT, Haffty BG. Prognostic significance of pretreatment hemoglobin for local control and overall survival in Tl-T2N0 larynx cancertreated with external beam radiotherapy [J]. Int J Radiat Oncol BioiPhys, 2004, 58(4): 1135-1140.
[14] Chua DT, Sham JS, Choy DT. Prognostic impact of hemoglobin levels on treatment outcome in patients with nasopharyngeal carcinoma treated with sequential chemoradiotherapy or radiotherapy alone [J]. Cancer, 2004, 101 (2): 307-316.
[15] Haugen H, Magnusson B, Svensson M, et al. Preradiotherapy haemoglobin level but not microvessel density predicts loooregional control and survivalin laryngeal cancer treated with primary radical radiotherapy [J]. Clin Cancer Res, 2004, 10(23): 7941-7949.
[16] Prosnitz RG, Yao B, Farrell CL, et al. Pretreatment anemia is correlated with the reduced effectiveness of radiation and concurrent chemotherapy in advanced head and neck cancer [J]. Int J Radiat Oncol Biol Phys, 2005, 61(4): 1087-1095.
[17] Herrmann FR, Safran C, Levkoff SE, et al. Serum albumin level on admission as a predictor of death, length of stay, and readmission [J]. Arch Intern Med, 1992, 152(1): 125-130.
[18] van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, et al. Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications [J]. Head Neck, 1997, 19(5): 419-425.
[19] Reid BC, Alberg AJ, Klassen AC, et al. A comparison of three comorbidity indexes in a head and neck cancer population [J]. Oral Oncol, 2002, 38(2): 187-194.
[20] Verschuur HP, Irish JC, O'Sullivan B, et al. A matched control study of treatment outcome in young patients with squamous cell carcinoma of the head and neck [J]. Laryngoscope, 1999, 109(2 Pt 1): 249-258.
[21] Siegelmann-Danieli N, Hanlon A, Ridge JA, et al. Oral tongue cancer in patients less than 45 years old: institutional experience and comparison with older patients [J]. J Clin Oncol, 1998, 16(2): 745-753.
[22] León X, Quer M, De Juan M, et al. Influence of age on laryngeal carcinoma [J]. Ann Otol Rhinol Laryngol, 1998, 107(2): 164-169.
[23] Koch WM, Brennan JA, Zahurak M, et al. p53 mutation and locoregional treatment failure in head and neck squamous cell carcinoma [J]. J Natl Cancer Inst, 1996, 88(21): 1580-1586.
[24] Borggreven PA, Kuik DJ, Quak JJ, et al. Comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and oropharynx with microvascular soft tissue reconstruction [J]. Head Neck, 2003, 25(10): 808-815.
[25] Paleri V, Wight RG, Silver CE, et al. Comorbidity in head and neck cancer: a critical appraisal and recommendations for practice [J]. Oral Oncol, 2010 , 46(10): 712-719.
[26] Sanabria A, Carvalho AL, Vartanian JG, et al. Comorbidity is a prognostic factor in elderly patients with head and neck cancer [J]. Ann Surg Oncol, 2007, 14(4): 1449-1457.
[27] Ribeiro KC, Kowalski LP, Latorre MR. Impact of comorbidity, symptoms, and patients' characteristics on the prognosis of oral carcinomas [J]. Archives Otolaryngol Head Neck Surg, 2000, 126(9): 1079-1085.
[28] Reid BC, Alberg AJ, Klassen AC, et al. Comorbidity and survival of elderly head and neck carcinoma patients [J]. Cancer, 2001, 92(8): 2109-2116.
[29] Riso S, Aluffi P, Brugnani M, et al. Postoperative enteral immunonutrition in head and neck cancer patients [J]. Clin Nutr, 2000, 19(6): 407-412.
[30] Johnson NW, Warnakulasuriya S, Gupta PC, et al. Global oral health inequalities in incidence and outcomes for oral cancer causes and solutions [J]. Adv Dent Res, 2011, 23(2): 237-246.
[31] Li G, Gao J, Liu ZG, et al. Influence of pretreatment ideal body weight percentile and albumin on prognosis of nasopharyngeal carcinoma: Long‐term outcomes of 512 patients from a single institution [J]. Head Neck, 2014, 36(5): 660-666.
[32] Liu SA, Tsai WC, Wong YK, et al. Nutritional factors and survival of patients with oral cancer [J]. Head Neck, 2006, 28(11): 998-1007.

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

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