Chedid Helma Maria, Franzi Sergio Altino
Ciências da Saúde do Hospital Heliópolis - Hosphel, São Paulo, SP.
Rev Assoc Med Bras (1992). 2008 Mar-Apr;54(2):127-31. doi: 10.1590/s0104-42302008000200014.
Salvage surgery is the first therapeutic option for recurrent tumors of the mouth and oropharynx, mainly in early stage tumors. This study intends to evaluate the disease free survival interval after salvage treatment for recurrent tumors of the mouth and oropharynx.
Retrospective analysis of 276 patients with squamous cell carcinoma of the mouth and oropharynx treated with surgery. One hundred and twenty seven patients developed loco-regional recurrence. Ninety-seven were staged as early tumors and 178 as advanced ones. The tumor site was the lip in 25 cases, oral cavity in 173 and oropharynx in 78. Postoperative radiotherapy was indicated in 121 cases with a mean dose of 60.8Gy.
Eighty-nine patients underwent salvage treatment (surgery in 76 patients). Loco-regional recurrences were treated with salvage surgery in 65% of cases. Disease free survival after salvage surgery was 13% in cases with recurrences diagnosed up to 6 months and 48% in those who recurred after 12 months of follow-up (p=0.0009). Modality of salvage treatment and the disease free interval were independent variables of survival in the multivariate analysis.
In cases clinically staged as I and II, the disease free survival in five years after salvage treatment was 70%.
挽救性手术是口腔和口咽复发肿瘤的首选治疗方法，主要用于早期肿瘤。本研究旨在评估口腔和口咽复发肿瘤挽救性治疗后的无病生存期。
回顾性分析276例接受手术治疗的口腔和口咽鳞状细胞癌患者。127例出现局部区域复发。其中97例为早期肿瘤，178例为晚期肿瘤。肿瘤部位为唇25例，口腔173例，口咽78例。121例患者术后接受放疗，平均剂量为60.8Gy。
89例患者接受了挽救性治疗（76例接受手术）。65%的局部区域复发患者接受了挽救性手术。复发诊断在6个月以内的患者挽救性手术后无病生存率为13%，随访12个月后复发的患者为48%（p=0.0009）。在多变量分析中，挽救性治疗方式和无病间期是生存的独立变量。
临床分期为I期和II期的患者，挽救性治疗后五年无病生存率为70%。
