Al-Rajhi N, Khafaga Y, El-Husseiny J, Saleem M, Mourad W, Al-Otieschan A, Al-Amro A
Department of Radiation Oncology, MBC 34, King Faisal Specialist Hospital and Research Center, PO Box 3354, 11211, Riyadh, Saudi Arabia.
Oral Oncol. 2000 Nov;36(6):508-14. doi: 10.1016/s1368-8375(00)00042-7.
The purpose of this study was to assess prognostic factors, treatment outcomes and patterns of relapse in patients with early stage (T1-2 N0) squamous cell carcinoma of oral tongue treated primarily by surgery. The medical records of all patients with early stage (T1-2 N0) oral tongue cancer, radically treated at King Faisal Specialist Hospital and Research Center between January 1980 and December 1997, were reviewed. Eighty-five patients were identified for analysis, 38 male and 47 female. With a median follow-up for surviving patients of 64 months, 5-year actuarial overall, disease-specific (DSS), and relapse-free survival (RFS) were 71, 75, and 63%, respectively. Univariate analysis for DSS showed survival advantage for patients with tumor thickness (TT) of < or =10 mm (P=0.0002) and distance from resection margin (DFRM) of > 5 mm (P=0.005). The effect of TT of < or =10 mm was maintained (P=0.001) on multivariate analysis. Higher RFS was observed with TT of < or =10 mm (P=0.0002), DFRM of > 5 mm (P=0.0002) and DFRM of >10 mm (P=0.007). On multivariate analysis higher RFS was also found for TT < or =10 mm (P=0.01) and DFRM >5 mm (P=0.01). Salvage of local tongue recurrence was higher than neck node failure, with 5-year DSS of 71 and 19%, respectively (P=0.007). Time interval for recurrence showed no significant impact on outcome. In T1-2 N0 oral tongue cancer, TT, and DFRM are significant prognostic factors for both local control and survival. Neck node recurrence is associated with poor prognosis and low salvage rate.
本研究的目的是评估主要接受手术治疗的早期（T1-2 N0）舌鳞状细胞癌患者的预后因素、治疗结果及复发模式。回顾了1980年1月至1997年12月期间在费萨尔国王专科医院和研究中心接受根治性治疗的所有早期（T1-2 N0）舌癌患者的病历。确定了85例患者进行分析，其中男性38例，女性47例。存活患者的中位随访时间为64个月，5年精算总生存率、疾病特异性生存率（DSS）和无复发生存率（RFS）分别为71%、75%和63%。DSS的单因素分析显示，肿瘤厚度（TT）≤10 mm的患者生存优势明显（P = 0.0002），切缘距离（DFRM）>5 mm的患者生存优势明显（P = 0.005）。多因素分析中，TT≤10 mm的影响依然存在（P = 0.001）。TT≤10 mm（P = 0.0002）、DFRM>5 mm（P = 0.0002）和DFRM>10 mm（P = 0.007）时观察到较高的RFS。多因素分析中，TT≤10 mm（P = 0.01）和DFRM>5 mm（P = 0.01）时也发现较高的RFS。舌部局部复发的挽救率高于颈部淋巴结转移失败，5年DSS分别为71%和19%（P = 0.007）。复发的时间间隔对结果无显著影响。在T1-2 N0舌癌中，TT和DFRM是局部控制和生存的重要预后因素。颈部淋巴结复发与预后不良和挽救率低相关。
