Hao Sheng-Po, Tsang Ngan-Ming, Chang Kai-Ping, Chen Chin-Kuo, Huang Shan-Sting
Department of Otolaryngology Head Neck Surgery, Chang Gung Cancer Center, Taipei, Taiwan.
Laryngoscope. 2006 Jun;116(6):916-20. doi: 10.1097/01.mlg.0000214900.07495.39.
Retromolar trigone (RMT) squamous cell carcinoma is uncommon but notorious for poor prognosis. We reviewed our experience in the management of RMT cancer to determine survival rates and to identify prognostic factors.
Fifty patients with RMT squamous cell carcinoma were treated with surgery and/or radiation or chemoradiation therapy between July 1993 and June 2004 at Chang Gung Memorial Hospital, Taiwan. Patients were followed up for 3 to 106 months (mean, 36 months). There were 6 stage I, 13 stage II, 4 stage II, and 27 stage N patients.
The 5-year actuarial survival rate for stage I to N and all stages were 100%, 74.1%, 75%, 43.6%, and 60.6%, respectively. Seventeen (34%) patients had maxilla bone (11 [22%]) or mandible bone (9 [18%]) invasion. Eleven (22%) patients had masticator space involvement. Cervical metastasis rate was 26%. Multivariate analysis revealed that masticator space involvement, neck recurrence, and cervical metastasis were poor prognosticators of survival by order. The maxilla bone was more apt to be involved by RMT cancer than the mandible. Patients with masticator space involvement had a 5-year actuarial survival rate of 22.5% and the mean survival time was only 37.8 months.
RMT squamous cell carcinomas are aggressive tumors. The maxilla is more apt to be involved than the mandible. Deep infiltration of the masticator space and invasion of the maxilla and mandible worsen the prognosis.
磨牙后三角区（RMT）鳞状细胞癌并不常见，但预后很差。我们回顾了我们在RMT癌治疗方面的经验，以确定生存率并识别预后因素。
1993年7月至2004年6月期间，台湾长庚纪念医院对50例RMT鳞状细胞癌患者进行了手术和/或放疗或放化疗。对患者进行了3至106个月（平均36个月）的随访。其中I期患者6例，II期患者13例，III期患者4例，IV期患者27例。
I期至IV期及所有阶段的5年精算生存率分别为100%、74.1%、75%、43.6%和60.6%。17例（34%）患者有上颌骨（11例[22%]）或下颌骨（9例[18%]）侵犯。11例（22%）患者有咀嚼肌间隙受累。颈部转移率为26%。多因素分析显示，咀嚼肌间隙受累、颈部复发和颈部转移依次是生存的不良预后因素。RMT癌侵犯上颌骨比下颌骨更常见。咀嚼肌间隙受累的患者5年精算生存率为22.5%，平均生存时间仅为37.8个月。
RMT鳞状细胞癌是侵袭性肿瘤。上颌骨比下颌骨更易受累。咀嚼肌间隙的深度浸润以及上颌骨和下颌骨的侵犯会使预后恶化。
