ABSTRACT
Objective@#To analyze the clinical characteristics of two groups(vascular classification declines or not in narrow band imaging (NBI) of patients with advanced hypopharyngeal carcinoma after induced chemotherapy, to follow-up and compare the survival differences between the two groups, and to explore the effect of vascular changes on clinical prognosis after induced chemotherapy in patients with advanced hypopharyngeal carcinoma.@*Methods@#Clinical data of 56 patients with advanced hypopharyngeal carcinoma from August 2014 to September 2016 in Beijing Tongren Hospital, Capital Medical University were collected. The patients were divided into two groups according to NBI vascular classification declines or not after induced chemotherapy. The survival of patients and the impact of different factors on the prognosis were retrospectively analyzed. SPSS 24.0 statistical software was used for analysis. Frequency data were compared between the two groups using χ2 test. Kaplan-Meier method and Cox regression analysis were employed for survival analysis and Log-Rank test was used for inter-group comparison, P<0.05 was statistically significant.@*Results@#There was significant difference in overall survival rate(OS) between two groups of patients with advanced hypopharyngeal carcinoma after induced chemotherapy (P<0.05). Multivariate analysis showed that NBI vascular classification changes after induced chemotherapy was the impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy.@*Conclusion@#In addition to recurrence and metastasis, NBI vascular classification changes is the important impact factor for prognosis of advanced hypopharyngeal carcinoma after induced chemotherapy. Patients with NBI vascular classification declines have significant survival benefit. The patients with advanced hypopharyngeal carcinoma should be checked with NBI examination before and after induced chemotherapy. NBI should be included in the routine screening indicators for prognosis of advanced hypopharyngeal carcinoma.
ABSTRACT
Objective@#To study the clinical characteristics of mucosal melanoma in the head and neck, including the risk factors affecting distant metastasis, recurrence and survival rate, and to provide the basis for the individualized treatment of mucosal melanoma in the head and neck.@*Methods@#The clinical data of 117 cases of mucosal melanoma in the head and neck treated from January 2004 to June 2016 in Beijing Tongren Hospital were analyzed retrospectively, and the risk factors affecting the prognosis, distant metastasis and local recurrence were analyzed.Kaplan-Meier analysis was used for survival analysis, and Log-Rank test was used for comparison between groups.@*Results@#The follow-up time was 5-139 months, with a median of 32 months, and the median survival time was 34 months.The 3 and 5 year cumulative survival rates were 47.0% and 25.0%, respectively.Local recurrence occurred in 27 patients (23.1%), and distant metastasis in 37 cases (31.6%). After the operation, 50 patients received radiotherapy.Multiple factor Cox regression analysis showed that distant metastasis, AJCC staging, and two operations were risk factors affecting survival (P<0.05), and immunologic/targeted therapy was a protective factor affecting survival prognosis(P=0.008). Postoperative radiotherapy and distant metastasis were important factors affecting recurrence (P<0.05). AJCC staging, pigmentation, and postoperative recurrence were risk factors for distant metastasis (P<0.05).@*Conclusion@#The 3 and 5 year survival rates of primary mucosal melanoma in head and neck are low, and the incidence of local recurrence and distant metastasis are high. Surgery is the first choice and the integrity of the initial operation has an important impact on the prognosis of the patients. Postoperative adjuvant radiotherapy is recommended to improve the local control rate, and immunotherapy and targeted therapy should be applied in time to improve survival.