Article record

日本北部III-IVA期喉鳞状细胞癌的真实世界手术结局与预后因素：一项多中心、回顾性队列研究

Real-world surgical outcomes and prognostic factors in stage III-IVA laryngeal squamous cell carcinoma: a multicenter, retrospective, cohort study in northern Japan.

临床研究咽喉科IF 3Q3

文献信息

PMID	42926249
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Akira Ohkoshi 查看其他 19 位作者 Katsunori Katagiri；Satoshi Kano；Kazutake Yagi；Hiroshi Idogawa；Satoshi Toyoma；Iori Kusaka；Takashi Kasai；Yukiko Saito；Kizuku Owada；Hisataka Ominato；Haruka Kaya；Eiichi Ishida；Kazuya Kurakami；Atsushi Yoshimura；Kenta Taguchi；Takuya Yoshida；Ryo Ishii；Kenjiro Higashi；Yukio Katori
作者单位	Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. akira.ohkoshi.e6@tohoku.ac.jp. 查看其他 13 条单位信息 Department of Otolaryngology-Head and Neck Surgery, Iwate Medical University School of Medicine, Iwate Medical University, Morioka, Japan.；Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.；Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Japan.；Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.；Department of Otorhinolaryngology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.；Department of Otolaryngology, Fukushima Medical University, Fukushima, Japan.；Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University, Sapporo, Japan.；Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan.；Department of Otorhinolaryngology and Head and Neck Surgery, Akita University Graduate School of Medicine, Akita, Japan.；Department of Otorhinolaryngology-Head and Neck Surgery, National Sendai Medical Center, Sendai, Japan.；Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Yamagata University, Yamagata, Japan.；Department of Otolaryngology, Head and Neck Surgery, Hokkaido Cancer Center, Sapporo, Japan.；Department of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
期刊	International journal of clinical oncology
SCI 分区	Q3
IF	3
研究类型	临床研究 · 临床
所属专科	咽喉科

中文摘要

背景： 本研究评估了接受手术治疗的III期和IVA期喉鳞状细胞癌（LASCC）患者多中心真实世界队列的肿瘤学结局，并识别与复发和死亡相关的预后因素，以为围手术期帕博利珠单抗时代的风险适应性治疗策略提供依据。
方法： 回顾性分析日本北部13家医院接受根治性意向手术的381例III-IVA期LASCC患者。根据治疗前临床因素和术后病理因素分析临床、病理、治疗和生存数据，包括无病生存期（DFS）、总生存期（OS）和疾病特异性生存期（DSS）。
结果： 在381例患者中，III期疾病的3年DFS、OS和DSS率分别为64.2%、85.2%和90.0%，IVA期疾病分别为49.5%、75.4%和78.9%。多因素Cox回归分析显示，年龄增加与III期疾病患者较差的生存独立相关。高危病理特征（结外侵犯或手术切缘阳性）与显著更差的生存相关。辅助同步放化疗（CCRT）给药不频繁，即使对高危患者也是如此。
结论： III期疾病患者术后结局良好，较年轻与更好的生存相关，而IVA期疾病或高危病理特征患者生存较差。这些发现提供了预后信息，可为风险适应性围手术期治疗策略提供依据。

英文摘要

BACKGROUND: This study evaluated oncological outcomes in a multicenter, real-world cohort of patients with stage III and IVA laryngeal squamous cell carcinoma (LASCC) undergoing surgery and identified prognostic factors associated with recurrence and mortality to inform risk-adapted treatment strategies in the era of perioperative pembrolizumab.
METHODS: A total of 381 patients with stage III-IVA LASCC who underwent curative-intent surgery at 13 hospitals in northern Japan were retrospectively analyzed. Clinical, pathological, treatment, and survival data, including disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS), were analyzed according to pretreatment clinical and postoperative pathological factors.
RESULTS: In the 381 patients, the 3-year DFS, OS, and DSS rates were 64.2%, 85.2%, and 90.0% in stage III disease and 49.5, 75.4, and 78.9% in stage IVA disease, respectively. Multivariate Cox regression analysis showed that increasing age was independently associated with poorer survival in patients with stage III disease. High-risk pathological features (extranodal extension or positive surgical margins) were associated with significantly worse survival. Adjuvant concurrent chemoradiotherapy (CCRT) was infrequently administered, even to high-risk patients.
CONCLUSIONS: Patients with stage III disease demonstrated good outcomes after surgery, with younger age associated with better survival, whereas those with stage IVA disease or high-risk pathological features had worse survival. These findings provide prognostic information to inform risk-adapted perioperative treatment strategies.