Garzino-Demo Paolo, Dell'Acqua Alessandro, Dalmasso Paola, Fasolis Massimo, La Terra Maggiore Gian Marco, Ramieri Guglielmo, Berrone Sid, Rampino Monica, Schena Marina
Division of Maxillofacial Surgery, Giovanni Battista Hospital, University of Turin, Italy.
J Craniomaxillofac Surg. 2006 Sep;34(6):344-50. doi: 10.1016/j.jcms.2006.04.004. Epub 2006 Jul 21.
This report analysed the outcome of patients undergoing surgery for oral squamous cell carcinoma in order to identify the prognostic value of several factors.
A total of 245 patients were studied who had undergone surgery for oral squamous cell carcinoma between 1989 and 2002, of whom 109 had received postoperative radiation therapy.
For each patient, personal data, alcohol and tobacco consumption, symptoms, histological findings, treatment, and outcome were recorded and analysed statistically. Survival curves were calculated using the Kaplan-Meier algorithm, and the difference in survival among subgroups was examined.
The overall 5-year survival rate in the 245 patients was 63% (72.5% at 3 years). The differences in the 5-year survival were significant (p<0.05) for the site of origin, N and pN status, TNM stage, grading, status of the resection margins, osseous infiltration, and perineural invasion. Vascular involvement as a discriminator was not statistically significant. In patients undergoing radiation therapy, only perineural invasion negatively influenced the 5-year survival prognosis (p<0.01).
The overall survival rate was within the (previously) reported range. The prognostic value of many parameters is widely recognized; the combined evaluation of 'composite factors' is promising.
本报告分析了接受口腔鳞状细胞癌手术患者的预后情况，以确定若干因素的预后价值。
共研究了245例在1989年至2002年间接受口腔鳞状细胞癌手术的患者，其中109例接受了术后放疗。
记录每位患者的个人资料、烟酒消费情况、症状、组织学检查结果、治疗情况及预后，并进行统计学分析。采用Kaplan-Meier算法计算生存曲线，并检验各亚组之间的生存差异。
245例患者的总体5年生存率为63%（3年时为72.5%）。原发部位、N和pN状态、TNM分期、分级、手术切缘状态、骨质浸润及神经周围浸润的5年生存率差异有统计学意义（p<0.05）。血管侵犯作为一个鉴别因素无统计学意义。在接受放疗的患者中，只有神经周围浸润对5年生存预后有负面影响（p<0.01）。
总体生存率在（之前）报道的范围内。许多参数的预后价值已得到广泛认可；“复合因素”的综合评估很有前景。
