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Überleben mit hämatogen metastasierten HNO-Tumoren

Eine retrospektive monozentrische Analyse

Survival with distant metastatic disease in head and neck cancer

A retrospective analysis

HNO volume 55, pages 785–791 (2007)Cite this article

Zusammenfassung

Hintergrund

Ein monozentrisches Kollektiv von 114 Patienten mit hämatogen metastasierten HNO-Tumoren wurde mit der Fragestellung untersucht, welche Parameter das Überleben beeinflussten.

Patienten und Methoden

Primärer Endpunkt der retrospektiven Untersuchung war das Überleben mit Fernmetastasen, sekundärer das Gesamtüberleben. Als potenziell endpunktrelevante Einflussparameter wurden Primärtherapie, Lokalrezidiv, Zweittumor, palliative Chemotherapie (CHT) und Radiotherapie (RT) sowie der Karnofsky-Performance-Status (KPS) zum Zeitpunkt der Metastasendiagnose univariat (Log-rank-Test) bzw. multivariat (Cox-Regression) analysiert.

Ergebnisse

Palliative CHT (p=0,0020) und der KPS bei Erstdiagnose von Metastasen (p=0,0011) beeinflussten univariat signifikant positiv die mediane Überlebenswahrscheinlichkeit mit Metastasen (8,2 Monate), als unabhängiger prognostischer Parameter verblieb der KPS (p=0,0013). Primärtherapie (p=0,0139), lokale Tumorkontrolle (p=0,0106) und der KPS (p=0,0096) beeinflussten univariat signifikant positiv die mediane Gesamtüberlebenswahrscheinlichkeit (18,5 Monate), ebenso multivariat (p=0,0123 bzw. p=0,0063 bzw. p=0,0197).

Schlussfolgerung

Als prognostisch unabhängiger Parameter für das Überleben mit Metastasen und das Gesamtüberleben verblieb der KPS zum Zeitpunkt der Metastasendiagnose. Solange eine Lebensverlängerung nicht evident ist, sollten daher in der palliativen Therapie die Stabilisierung des KPS und der Lebensqualität im Vordergrund stehen.

Abstract

Questions

The objective of this retrospective analysis was to investigate parameters with a potential impact on survival in a collective of 114 patients with distant metastatic disease after head and neck cancer.

Patients and methods

The primary endpoint was the survival with distant metastatic disease, the secondary endpoint was overall survival. Primary therapy, local recurrence, second neoplasms, palliative chemotherapy (CHT) and radiotherapy (RT), as well as Karnofsky performance status (KPS) at the time of diagnosis of the metastases were analyzed as potential impact parameters using the log-rank test with subsequent Cox regression analysis.

Results

Palliative CHT (P=0.0020) and KPS (P=0.0011) had a significant positive impact on the median survival probability with metastases (8.2 months) using the log-rank test, KPS at the time of diagnosis of metastases remained as an independent prognostic parameter in the Cox regression (P=0.0013). Primary therapy, local tumor control and KPS had a significant positive influence on the median overall survival probability (18.5 months) univariately (P=0.0139, P=0.0106, P= 0.0096) and multivariately (P=0.0123, and P=0.0063, P=0.0197, respectively).

Conclusions

KPS at the time of diagnosis of metastases is an independent prognostic parameter for both endpoints. Lacking evidence for life prolongation, palliative therapies should therefore first and foremost focus on the stabilization of the KPS.

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Affiliations

  1. Klinik für Strahlentherapie, Universität Regensburg, Franz Josef Strauss Allee 11, 93053, Regensburg, Deutschland

    B. Dietl, C. Schaefer, F. Pohl & O. Kölbl

  2. Abteilung für Nuklearmedizin, Universität Regensburg, Regensburg, Deutschland

    J. Marienhagen

  3. Klinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Regensburg, Deutschland

    T. Murthum

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  1. B. Dietl
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  2. J. Marienhagen
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  3. C. Schaefer
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  4. F. Pohl
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  5. T. Murthum
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  6. O. Kölbl
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Correspondence to B. Dietl.

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Dietl, B., Marienhagen, J., Schaefer, C. et al. Überleben mit hämatogen metastasierten HNO-Tumoren. HNO 55, 785–791 (2007). https://doi.org/10.1007/s00106-006-1522-4

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Schlüsselwörter

  • HNO-Tumore
  • Fernmetastasen
  • Lokalrezidiv
  • Zweittumor
  • Überleben

Keywords

  • ENT tumors
  • Distant metastatic disease
  • Local recurrence
  • Second primary
  • Survival