摘要
目的探讨下咽癌合并多原发癌的发病率、临床特点、治疗及预后情况。方法回顾分析2005年1月~2015年12月本科收治的476例下咽癌患者的临床资料,按照多原发癌的诊断标准分为多原发癌组与下咽癌组,比较2组患者的临床特点。结果 63例合并多原发癌,占13.2%,均为双重癌。其中同时性多原发癌14例、异时性多原发癌49例,异时性多原发癌最短时间间隔为8个月,最长20年。有48例多原发癌是在下咽癌发生的5年内被发现的,占76.2%。多原发癌中食管癌35例(55.6%),其次为肺癌5例(7.9%)。多原发癌组患者主要死于其他原发癌。多原发癌组的3年、5年总生存率分别为45.5%和33.3%,下咽癌组的3年、5年总生存率分别为47.7%和35.2%。结论下咽癌合并多原发癌以食管癌多见,在下咽癌发生的5年内高发,多原发癌对下咽癌预后有影响,因此下咽癌根治性治疗后应重视长期密切随访。
Objective To investigate the prevalence, clinical features, treatment and prognosis of hypopharyngeal carcinoma associated with multiple primary malignant tumors （MPMT）. Methods A retrospective analysis of clinical data was performed in 476 patients with hypopharyngeal carcinoma who underwent curative resection between January 2005 and December 2015. According to the diagnosis standard of MPMT, patients were classified into MPMT group and single cancer group. Results MPMT were detected in 63 patients （ 13.2% ）. All of the cases had two primary cancers. Fourteen patients had synchronous cancers and 49 patients had metachronous cancers. For metachronous group, the time interval between the first and secondary primary cancer was from 8 months to 20 years. Forty-eight cases （76.2%） were diagnosed with MPMT within 5 years. The most common site of MPMT was the esophagus （35 cases, 55.6% ）, followed by the lung （5 cases, 7.9% ）. Patients with MPMT were predominantly died of primary tumor of other site. The 3-year and 5-year overall survival （ OS ） rates of patients with MPMT were 45. 5% and 33. 3% , respectively. The 3-year and 5-year OS rates of patients with single cancer were 47.7% and 35.2%, respectively. Conclusions MPMT most commonly occurs in the esophagus in patients with hypopharyngeal carcinoma. MPMT has high incidence within five years and can affect the prognosis of hypopharyngeal carcinoma. A close and long-term follow- up for occurrence of MPMT after curative treatment for hypopharyngeal carcinoma is necessary.
作者
李敏
曹轶倓
谢明
周梁
LI Min CAO Yi-tan XIE Ming ZHOU Liang.(Department of Otolaryngology, Eye Ear Nose and Throat Hospital of Fudan University, Shanghai 200031, China)
出处
《中国眼耳鼻喉科杂志》
2017年第5期337-341,共5页
Chinese Journal of Ophthalmology and Otorhinolaryngology
基金
上海市级医院新兴前沿技术联合攻关项目(SHDC12015114)
关键词
下咽癌
多原发癌
预后
Hypopharyngeal carcinoma
Multiple primary malignant tumors
Prognosis
