Bier-Laning Carol M, Durazo-Arvizu Ramon, Muzaffar Kamil, Petruzzelli Guy J
Department of Otolaryngology-Head and Neck Surgery, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Laryngoscope. 2009 May;119(5):883-8. doi: 10.1002/lary.20141.
OBJECTIVES/HYPOTHESIS: Contralateral cervical metastases represent an avoidable source of failure in squamous cell carcinoma (SCCa) of the oral tongue. We sought to identify risk factors for the development of contralateral cervical metastases in T1/T2 oral tongue SCCa.
Retrospective review.
We reviewed the medical records of 50 sequential cases of Stage I/II SCCa of the oral tongue treated with surgery between 1983 and 2003 at Loyola University Medical Center and Hines VA Hospital. Clinical staging, primary tumor thickness, results of neck dissection, adjuvant treatment, site and date of recurrence, and final outcome were recorded. Follow-up ranged from 0.2 to 17 years, with a mean of 5 years. Data were analyzed using multivariate logistic, Cox regression analysis, and a classification and logistic regression tree analysis.
The odds ratio for risk of developing contralateral neck metastasis was 5% for each 1 mm increase in tumor thickness (P = .68). The risk did not change when controlling for the presence of ipsilateral metastasis. There was a significant relationship between contralateral cervical metastases and the development of recurrent disease at any site (P = .005). Classification tree analysis determined the risk for contralateral metastases and was greatest for patients with tumors > 3.75 mm thick and < or = 9.5 mm thick.
This report is the first to our knowledge that evaluates thickness as a risk factor for contralateral cervical metastasis in oral tongue SCCa. We recommend consideration be given to treating the contralateral neck in cases where the primary tumor is > 3.75 mm thick.
目的/假设：对侧颈部转移是口腔舌鳞状细胞癌（SCCa）中一个可避免的失败来源。我们试图确定T1/T2期口腔舌SCCa发生对侧颈部转移的风险因素。
回顾性研究。
我们回顾了1983年至2003年在洛约拉大学医学中心和海因斯退伍军人医院接受手术治疗的50例连续性I/II期口腔舌SCCa患者的病历。记录临床分期、原发肿瘤厚度、颈部清扫结果、辅助治疗、复发部位和日期以及最终结局。随访时间为0.2至17年，平均5年。使用多变量逻辑回归、Cox回归分析以及分类和逻辑回归树分析对数据进行分析。
肿瘤厚度每增加1毫米，发生对侧颈部转移的风险比值比为5%（P = 0.68）。在控制同侧转移的存在时，该风险没有变化。对侧颈部转移与任何部位复发性疾病的发生之间存在显著关系（P = 0.005）。分类树分析确定了对侧转移的风险，对于肿瘤厚度> 3.75毫米且≤ 9.5毫米的患者风险最高。
据我们所知，本报告是首个评估厚度作为口腔舌SCCa对侧颈部转移风险因素的研究。我们建议，对于原发肿瘤厚度> 3.75毫米的病例，考虑对侧颈部治疗。
