Dequanter D, Saint-Aubin N, Paesmans M, Badr-El-Din A, Lothaire P, Andry G
Département de chirurgie, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles.
Ann Otolaryngol Chir Cervicofac. 2001 Oct;118(5):315-22.
Our aim was to evaluate the results and the prognosis of squamous cell carcinoma of the mobile part of the tongue stage T1-T2 treated by surgery and radiotherapy at the Institute Jules Bordet from January 1950 to 31th December 1993.
According to the classification TNM (UICC 1978) 165 consecutive patients classified as follow: 73 T1No (stage I), 64 T2No (stage II), 7 T1N1 and 20 T2N1 (stage III) and 1 patient T2N2 (stage IV). All patients underwent surgery beforehand. 136 patients received additional brachytherapy.
In this study were included 117 men and 48 women with an average age of 60 years. The rate of relapse on the primary tumoral site amounted to 16,4% and the residual relapse to 40%. The survival note without relapse was evaluated respectively at 3 years in 67% of the tumours T1 (against 28% for the T2), at 5 years for 59% for tumours T1 (against 26% for T2). From the clinical point of view the survival rate without relapse was of 5 years for 61% of stage I, 29% of stage II and 24% of stage III. A more extensive investigation shows the statistic influence, such as age (p<0.004), size of the tumour (p<0.007) and its shape (p<0.0007) on the total survive rate. The state of the nodes (p<0.02) and the safety margins (p<0.04) are statistically less associated. The survival rate with no relapse according to a study considering statistical factors, is significantly influenced by the size (p<0.0002) and age (p<0.0003).
T1-T2 stages of the mobile tongue are characterized by a limited local spread but a more regional spread and diversified therapeutic approach with prognostic factors influencing the survival rate without forgetting the part played by the TNM classification.
我们的目的是评估1950年1月至1993年12月31日在朱尔斯·博尔代研究所接受手术和放疗的舌活动部T1 - T2期鳞状细胞癌的治疗结果和预后。
根据TNM分类（UICC 1978），165例连续患者分类如下：73例T1No（I期），64例T2No（II期），7例T1N1和20例T2N1（III期）以及1例T2N2（IV期）。所有患者均预先接受手术。136例患者接受了额外的近距离放疗。
本研究纳入117名男性和48名女性，平均年龄60岁。原发肿瘤部位的复发率为16.4%，残留复发率为40%。T1期肿瘤3年无复发生存率为67%（T2期为28%），T1期肿瘤5年无复发生存率为59%（T2期为26%）。从临床角度看，I期5年无复发生存率为61%，II期为29%，III期为24%。更广泛的调查显示年龄（p<0.004）、肿瘤大小（p<0.007）及其形状（p<0.0007）对总生存率有统计学影响。淋巴结状态（p<0.02）和安全切缘（p<0.04）在统计学上相关性较小。根据一项考虑统计因素的研究，无复发生存率受肿瘤大小（p<0.0002）和年龄（p<0.0003）的显著影响。
舌活动部的T1 - T2期特点是局部扩散有限，但区域扩散更明显，治疗方法多样，预后因素影响生存率，同时不忘TNM分类所起的作用。
