Comparison of 5-year survival rate and analysis of prognostic factors influencing the prognosis of adenoid cystic carcinoma and squamous cell carcinoma of the maxillary sinus: based on the SEER database
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摘要: 目的 利用美国国家癌症研究所监测、流行病学和最终结果数据库(SEER)，分析上颌窦腺样囊性癌(maxillary sinus adenoid cystic carcinoma，MSACC)与上颌窦鳞状细胞癌(maxillary sinus squamous cell carcinoma，MSSCC)的5年生存率差异，并探讨2种肿瘤的预后影响因素。方法 收集SEER数据库2004—2015年间161例MSACC患者及929例MSSCC患者数据，分别比较2组患者倾向性得分匹配前后5年总体生存率(overall survival，OS)和肿瘤特异性生存率(cancer specific survival，CSS)的差异。并建立多因素Cox比例风险回归分析模型的森林图，分析MSACC与MSSCC患者的预后影响因素。结果 倾向性得分匹配前后MSACC与MSSCC的5年OS、CSS比较差异均有统计学意义(P < 0.001)。多因素回归分析显示年龄、发病侧别、淋巴结转移、手术和放疗是MSACC的OS的影响因素，年龄和手术是其CSS的影响因素。年龄、种族、T分级、淋巴结转移、全身转移、手术、放疗和化疗是MSSCC的OS的影响因素，年龄、T分级、淋巴结转移、全身转移、手术、放疗和化疗是其CSS的影响因素。结论 MSACC的5年生存率高于MSSCC，手术对其预后均有积极意义，但放疗和化疗对2种肿瘤预后影响存在差异，分析结果可为其的生存预期和治疗选择提供理论参考。Abstract: Objective To analyze the difference in 5-year survival between maxillary sinus adenoidal cystic carcinoma(maxillary sinus adenoid cystic carcinoma, MSACC) and squamous cell carcinoma(maxillary sinus squamous cell carcinoma, MSSCC) using the National Cancer Institute's Surveillance, Epidemiology, and End.Results database(SEER) and to explore the factors associated with the prognosis of the two tumors.Methods The data of 161 patients with MSACC and 929 patients with MSSCC were collected from SEER database, and the 5-year overall survival rate(OS) and tumor specific survival rate(CSS) were compared between the two groups before and after propensity score matching. The forest map of multivariate Cox proportional hazard regression model was established to analyze the prognostic factors affecting the survival rate of patients with MSACC and MSSCC. Results: There were statistical differences in 5-year OS and CSS between MSACC and MSSCC before and after propensity score matching(P < 0.001). Multivariate regression analysis showed that age, side of the disease, lymph node metastasis, operation and radiotherapy were the influencing factors of OS in MSACC, while age and operation were the influencing factors of CSS. Age, race, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of OS of MSSCC. Age, T grade, lymph node metastasis, systemic metastasis, surgery, radiotherapy and chemotherapy are the influencing factors of CSS.Conclusion The 5-year survival rate of MSACC is higher than that of MSSCC. Surgery plays a positive role in the prognosis of the two kinds of tumors. The analysis results can provide some reference for their survival expectations and treatment choices.
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表 1 MSACC与MSSCC患者3、5年OS以及CSS
M(P25，P75) 组别 OS/% CSS/% 3年 5年 3年 5年 MSACC 73.0(66.4，80.2) 56.8(49.6，65.1) 78.9(72.7，85.7) 63.3(56.0，71.7) MSSCC 40.0(36.9，43.3) 32.0(29.1，35.1) 48.7(45.4，52.2) 42.0(38.7，45.5) 
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