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Abstract：
BACKGROUND: The management of paranasal sinus and nasal cavity malignancies has evolved significantly with the development of advanced endoscopic techniques and improvements in adjuvant therapy. We sought to characterize both disease-specific survival (DSS) and 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for sinus malignancies diagnosed before and after the year 2000.
METHODS: Patients diagnosed with sinus and nasal cavity cancer between 1973-2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by year of diagnosis before and after 2000. Cox-proportional hazards models of DSS controlling for stage, age, and year of diagnosis were generated. CDSS was calculated using Cox-regression models stratified by stage.
RESULTS: We analyzed 10,535 patients. Diagnosis after the year 2000 was independently associated with improved DSS (HR:0.81, 95% CI: 0.75-0.87, P < .001) after controlling for age and stage. After stratifying by stage, diagnosis after year 2000 was associated with improved DSS for localized (HR:0.71, 0.59-0.86, P < .001) malignancies, regional (HR: 0.86, 0.78-0.94, P = .001) and distant malignancies (HR 0.74, 0.63-0.87, P < .001). CDSS improved with increasing survivorship for all stages of sinus and nasal cavity cancer, and those diagnosed after 2000 had improved CDSS compared to those diagnosed before 2000. Descriptively, the association of year of diagnosis with CDSS diminished with increasing survivorship for localized cancers, but was consistent for other stages.
CONCLUSIONS: For paranasal sinus and nasal cavity malignancies, year of diagnosis independently influences both DSS and CDSS. Improved survival is likely due to advances in both surgical and adjuvant treatments. To our knowledge, this study is the first to examine CDSS for these malignancies.
METHODS: Patients diagnosed with sinus and nasal cavity cancer between 1973-2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry. Kaplan-Meier analysis for DSS was stratified by year of diagnosis before and after 2000. Cox-proportional hazards models of DSS controlling for stage, age, and year of diagnosis were generated. CDSS was calculated using Cox-regression models stratified by stage.
RESULTS: We analyzed 10,535 patients. Diagnosis after the year 2000 was independently associated with improved DSS (HR:0.81, 95% CI: 0.75-0.87, P < .001) after controlling for age and stage. After stratifying by stage, diagnosis after year 2000 was associated with improved DSS for localized (HR:0.71, 0.59-0.86, P < .001) malignancies, regional (HR: 0.86, 0.78-0.94, P = .001) and distant malignancies (HR 0.74, 0.63-0.87, P < .001). CDSS improved with increasing survivorship for all stages of sinus and nasal cavity cancer, and those diagnosed after 2000 had improved CDSS compared to those diagnosed before 2000. Descriptively, the association of year of diagnosis with CDSS diminished with increasing survivorship for localized cancers, but was consistent for other stages.
CONCLUSIONS: For paranasal sinus and nasal cavity malignancies, year of diagnosis independently influences both DSS and CDSS. Improved survival is likely due to advances in both surgical and adjuvant treatments. To our knowledge, this study is the first to examine CDSS for these malignancies.
摘要：
背景：随着先进的内窥镜技术的发展和辅助治疗的改进，鼻窦和鼻腔恶性肿瘤的治疗有了显著的发展。我们试图表征疾病特异性生存期(DSS)和5年条件性疾病特异性生存期(CDSS，在2000年之前和之后诊断出的鼻窦恶性肿瘤的预期寿命随着存活率的增加而变化）。
方法：从监测中提取1973-2015年间诊断为鼻窦和鼻腔癌的患者，流行病学,结束结果(SEER)注册表。根据2000年前后的诊断年份对DSS的Kaplan-Meier分析进行分层。舞台DSS控制的Cox比例风险模型，年龄,并生成了诊断年份。使用Cox回归模型按阶段分层计算CDSS。
结果：我们分析了10535例患者。在控制年龄和分期后，2000年后的诊断与改善的DSS独立相关（HR：0.81，95％CI：0.75-0.87，P<.001）。按阶段分层后，2000年后的诊断与局部（HR：0.71，0.59-0.86，P<.001）恶性肿瘤的DSS改善有关，区域（HR：0.86，0.78-0.94，P=.001）和远处恶性肿瘤（HR0.74，0.63-0.87，P<.001）。CDSS随着鼻窦和鼻腔癌各阶段生存率的增加而改善，与2000年之前诊断的患者相比，2000年之后诊断的患者的CDSS有所改善。描述性的,诊断年份与CDSS的关联随着局部癌症生存率的增加而减弱，但在其他阶段是一致的。
结论：对于鼻旁窦和鼻腔恶性肿瘤，诊断年份独立影响DSS和CDSS。生存率的提高可能是由于手术和辅助治疗的进步。据我们所知,这项研究是首次检查这些恶性肿瘤的CDSS。
方法：从监测中提取1973-2015年间诊断为鼻窦和鼻腔癌的患者，流行病学,结束结果(SEER)注册表。根据2000年前后的诊断年份对DSS的Kaplan-Meier分析进行分层。舞台DSS控制的Cox比例风险模型，年龄,并生成了诊断年份。使用Cox回归模型按阶段分层计算CDSS。
结果：我们分析了10535例患者。在控制年龄和分期后，2000年后的诊断与改善的DSS独立相关（HR：0.81，95％CI：0.75-0.87，P<.001）。按阶段分层后，2000年后的诊断与局部（HR：0.71，0.59-0.86，P<.001）恶性肿瘤的DSS改善有关，区域（HR：0.86，0.78-0.94，P=.001）和远处恶性肿瘤（HR0.74，0.63-0.87，P<.001）。CDSS随着鼻窦和鼻腔癌各阶段生存率的增加而改善，与2000年之前诊断的患者相比，2000年之后诊断的患者的CDSS有所改善。描述性的,诊断年份与CDSS的关联随着局部癌症生存率的增加而减弱，但在其他阶段是一致的。
结论：对于鼻旁窦和鼻腔恶性肿瘤，诊断年份独立影响DSS和CDSS。生存率的提高可能是由于手术和辅助治疗的进步。据我们所知,这项研究是首次检查这些恶性肿瘤的CDSS。
