Mishra R C, Parida G, Mishra T K, Mohanty S
Acharya Harihar Regional Cancer Centre, Orissa, India.
Eur J Surg Oncol. 1999 Apr;25(2):186-9. doi: 10.1053/ejso.1998.0624.
The TNM system is the main parameter in treatment planning and the prediction of survival in oral cancer. Here, we investigate the role of tumour thickness as a predictor of locoregional failure and survival in node-negative patients.
We studied 176 node-negative and early stage gingivo-buccal squamous cell carcinoma patients retrospectively. Clinico-pathological factors investigated for tumour failure prediction were: T stage; tumour differentiation; tumour thickness; and treatment. Tumour thickness was measured using an ocular micrometer.
Locoregional tumour failure was found in 34% of cases (60 of 176). Tumour differentiation was found not to be statistically significant in predicting tumour failure. The covariates predicting tumour failure were T stage (P<0.05); type of surgical treatment (P<0.05); and tumour thickness (P<0.001). The mean tumour thickness found was 4 mm. Tumours 4 mm in thickness behaved similarly in all three stages and those >4 mm had a higher rate of lymph-node metastasis. No distant metastasis was found in this series.
Tumour thickness was found to be an accurate predictor of locoregional failure in early stage cancer of the buccal mucosa.
TNM系统是口腔癌治疗计划制定及生存预后预测的主要参数。在此,我们研究肿瘤厚度作为无淋巴结转移患者局部区域复发及生存预后预测指标的作用。
我们回顾性研究了176例无淋巴结转移的早期牙龈颊部鳞状细胞癌患者。用于预测肿瘤复发的临床病理因素包括:T分期;肿瘤分化程度;肿瘤厚度;以及治疗方式。使用目镜测微计测量肿瘤厚度。
34%的病例(176例中的60例)出现局部区域肿瘤复发。发现肿瘤分化程度在预测肿瘤复发方面无统计学意义。预测肿瘤复发的协变量为T分期(P<0.05);手术治疗方式(P<0.05);以及肿瘤厚度(P<0.001)。所测肿瘤平均厚度为4毫米。厚度为4毫米的肿瘤在所有三个分期中的表现相似,而厚度>4毫米的肿瘤有更高的淋巴结转移率。本系列研究中未发现远处转移。
肿瘤厚度被发现是颊黏膜早期癌局部区域复发的准确预测指标。