Liao Chun-Ta, Ng Shu-Hang, Chang Joseph Tung-Chieh, Wang Hung-Ming, Hsueh Chuen, Lee Li-Yu, Tsao Chung-Kan, Chen Wen-Ho, Chen I-How, Kang Chung-Jan, Huang Shiang-Fu, Yen Tzu-Chen
Departments of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, Taoyuan, Taiwan.
Oral Oncol. 2007 Jul;43(6):570-9. doi: 10.1016/j.oraloncology.2006.06.008. Epub 2006 Sep 25.
According to the AJCC 2002 staging system, squamous cell carcinoma of the oral cavity (OSCC) with T4b is unresectable. Herein, we report on our surgical outcome for T4b OSCC. All patients were enrolled before 2002. From January 1996 to December 2000, 45 consecutive untreated T4b OSCC patients were included. According to the trans-axial plane of the mandibular notch on CT/MRI, seven were supra-notch T4b and 38 were infra-notch T4b tumors. Significantly higher 5-year loco-regional control and survivals were observed in patients with infra-notch T4b than with supra-notch T4b. In the infra-notch group, pN0-1 patients had a significantly higher 5-year loco-regional control and survivals than pN2 patients. Nerve invasion was the sole significant adverse factor for loco-regional control and survivals in the infra-notch T4b group with pN0-1. Our retrospective study demonstrated that OSCC patients of infra-notch T4b with pN0-1 and no nerve invasion might have a favorable surgical outcome.
根据美国癌症联合委员会（AJCC）2002年分期系统，T4b期口腔鳞状细胞癌（OSCC）无法切除。在此，我们报告T4b期OSCC的手术结果。所有患者均于2002年前入组。1996年1月至2000年12月，纳入45例未经治疗的连续性T4b期OSCC患者。根据CT/MRI上下颌切迹的横轴平面，7例为切迹上T4b期肿瘤，38例为切迹下T4b期肿瘤。切迹下T4b期患者的5年局部区域控制率和生存率显著高于切迹上T4b期患者。在切迹下组中，pN0-1患者的5年局部区域控制率和生存率显著高于pN2患者。神经侵犯是切迹下T4b期且pN0-1组局部区域控制和生存的唯一显著不良因素。我们的回顾性研究表明，切迹下T4b期、pN0-1且无神经侵犯的OSCC患者可能有良好的手术结果。
